Erythema induratum of Bazin (EIB) belongs to a group of diseases characterized by inflammatory nodules of the leg which primarily involve the lower legs. EIB is considered to be a reactive disorder related to several etiologic factors. In Korea, most dermatologists accept the tuberculosis as one of the most common etiology of EIB. As the number of EIB cases is decreasing in Korea in accordance with the decreased incidence of tuberculosis, EIB can be easily mistaken for any of the disease that produces chronic nodular eruptions on the legs. In Korea, important factors to make a correct diagnosis of EI include clinicopathologic observations coupled with the identification of hypersensitivity to tuberculous antigen and successful treatment of anti-tuberculous medication.
Adjustment Disorders ; Erythema ; Erythema Induratum ; Hypersensitivity ; Incidence ; Korea ; Leg ; Tuberculosis

Erythema induratum and erythema nodosum are both inflammatory disorders of the panniculus. However they are often difficult to distinguish because of clinical variations and similarity of histopathologic features. We investigated the clinical and histopathologic features of 30 cases of erythema induratum and 38 cases of erythema nodosum in order to define discrimination of clinical and histopathologic features. The results show that presence of ulceration is clinically important in differentiating erythema induratum from erythema nodosum. Histopathologic findings which suggest erythema induratum include lobular panniculitis or lobuloseptal panniculitis, necrosis and necrotizing vasculitis while erythema nodosum is characterized by predominantly septal panniculitis without necrosis and necrotizing vasculitis.
Discrimination (Psychology) ; Erythema Induratum* ; Erythema Nodosum* ; Erythema* ; Necrosis ; Panniculitis ; Ulcer ; Vasculitis

Sixty-six cases of erythena nodosum(EN) and erythema induraturn(EI) were examined pathologically and clinically. Pathologically 23 cases were erythema nodosum, 43 cases were erytherna induratum. Pathological diagnosis made without any prior knowledge of the clinical and laboratory data. Clinical manifestations were reviewed on basis of pathological diagnosis. The results are as follows; l. EN and EI mainly occurred in female, age of twenties and during spring season. There was no difference in sex, age and seasonal incidence between EN and EI. 2. Both EN and EI affected chiefly the shins. EI was more common than EN in cases of calf involvement. 3. Tenderness and systemic symptoms developed more often in EN, while ulcers occurred only in EI. 4 EI had relatively long duration. There was no difference in the recurrence rate between EN and EI. 5. Pulmonary tuberculosis was found only in El on chest X-rays. 6. Clinical and pathological diagnosis was identical in almost cases of EN but those were variable in case of EI.
Diagnosis ; Erythema Induratum* ; Erythema Nodosum* ; Erythema* ; Female ; Humans ; Incidence ; Recurrence ; Seasons ; Thorax ; Tuberculosis, Pulmonary ; Ulcer

BACKGROUND: The inflammatory nodules on the legs are often difficult to distinguish because of clinical variations and similarity of histopathologic features. Both erythema nodosum and erythema induratum are known to be associated with various conditions, especially tuberculosis. In Korea where tuberculosis is still a major health problem, it may be a cause for the inflammatory nodules on the legs. OBJECTIVE: The purpose of this study was to establish the correlation with Mantoux test and inflammatory nodule and evaluate the efficacy of antitubercular therapy in Korea. METHODS: We performed the prospective study of 26 patients with inflammatory nodules on the legs. All patients preformed Mantoux test and skin biopsy. The patients who had strongly positive Mantoux reaction were treated with antitubercular therapy. RESULTS: The ages of the 26 patients (Male 4:Female 22) ranged from 12 to 76 years. All patients had recurrent painful, tender subcutaneous nodules on the legs. Fourteen patients of total 26 patients had a strongly postive Mantoux reaction (induration > or = 20 mm). They were treated with combination antitubercular therapy. After antitubercular therapy, skin lesions subsided in 12 patients within 2 months and in the remaining 2 patients, subsided within 4 months. The therapy was well tolerated except for flu-like symptom in one patient and drug induced hepatitis in the other patient. CONCLUSION: We suggest that antitubercular therapy is effective in the management of patients with a strongly positive Mantoux reaction with chronic recurrent inflammatory nodules on the legs in Korea.
Biopsy ; Erythema Induratum ; Erythema Nodosum ; Hepatitis ; Humans ; Korea ; Leg* ; Prospective Studies ; Skin ; Tuberculosis

We report a rare case in which two tuberculids, erythema induratum and papulonecrotic tuberculid, occured together. A 15-year-old Korean girl had two types of clinically distinct lesions; painful subcutaneous nodules on the legs and pruritic necrotic papules on the trunk and extremity. Mantoux test showed a strong positive reaction. Histopathologic findings of the subcutaneous nodule and necrotic papule were consistent with erythema induratum and papulonecrotic tuberculid, respectively. There was no extracutaneous focus of tuberculosis. Polymerase chain reaction for tuberculosis bacilli in both lesions revealed negative results. Antituberculous therapy brought a rapid clinical improvement of lesions within a month.
Adolescent ; Erythema Induratum* ; Erythema* ; Extremities ; Female ; Humans ; Leg ; Polymerase Chain Reaction ; Tuberculosis ; Tuberculosis, Cutaneous*

A clinical and histopsthological study were done on 1,817 biopsied inflammatory skin diseases among 58,386 out-patients in Dermatologic department of Korea University Hospital during the period of 24 years from January, 1962 to December, 1985. The results were summarized as follows : 1. According to pattern analysis(Ackerman AB), 1,605 cases(88.3%) of inflammatory skin diseases were classified into 9 patterns and by author's modified pattern analysis, additional 437 cases could be classified. 2. Of the 1605 cases which were classified by 9 pattern analysis, 1185 cases(78.8%) of inflammatory skin diseases were diagnosed as individual disease entity. The ratio of accordance between the histopathological diagnosis and clinical diagnosis on the biopsied inflammatory skin diseases was 44.5%, 3. The ratio of accordance between the histopathological diagnosis and clinical diagnosis by the patterns were '. Vasculitis(75.5%), Subepidermal vesicular dermatitis (73.3%), Nodular and diffuse dermatitis(68.2%), etc. 4. The diseases showing above the 70% accordance were scleroderma, erythema induratum, vitiligo, arthropod reaction, etc; and the diseases showing under the 30% accnrdance were erythema multiforme, erythema annulare centrifugum, neurodermatitis, etc.
Arthropods ; Biopsy* ; Dermatitis ; Diagnosis ; Erythema ; Erythema Induratum ; Erythema Multiforme ; Humans ; Korea ; Neurodermatitis ; Outpatients ; Skin Diseases* ; Skin* ; Vitiligo

Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin diseases. It is charaeterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance and microgranules in the subcutis with massive fat necrosis. The eosinophilic lining and microgranules stain positively with periodic acid-Schiff, are resistant to diastase, and also stain with Sudan black B. We report three cases of subcutanous membranous lipodystrophy in patients with erythema induratum, posttraumatic panniculitis and morphea with typical clinical and histopathologic findings.
Amylases ; Eosinophils ; Erythema Induratum ; Fat Necrosis ; Humans ; Lipodystrophy* ; Panniculitis ; Scleroderma, Localized ; Skin Diseases ; Sudan

A clinical and histopathologic study was done on 48 cases of cutaneous tuberculosis among 43, 209 out-patients in Dermatologic department of Korea t.Jniversity Hospital during the period of 15 years and 9 mont4s from January, 1969 to September, 1984. These 48 cases were consistent with skin tuberculosis in histologic and clinicalI finc1ings, The result were summarized as follows: ]. The incidence of skin tuberculosis was 0 I 1 g among 43, 209 cases of outpatients. 2. Localized type of skin tuberculosis was 3. 2 times more frequent than disseminated type. Frequent skin tuberculosis was lupus vulgaris (57 3%), erythema induratum (12, 5%), tuberculosis verrucosa cutis(8.3%) and lupus milaris disseminatus faciei (8. 3%). 4, The ratio between male and fenmle was 1: l. 1. 5 The ages of onset were variable according to the types of skin tuberculosis. but 45 8% of all cases developed in the age group between 10 and 29 years. Seasonal incidences of skin tuberculosis were 52. 1% in spring, 85%, in winter, 18. 8% in summer, 4, 2%, in autumn. 7 In histopathologic findings, there were tubercle or tubrculoid structures in all cases and typical tubercle structures were observed in 18.8% The ratio of accordance between the histopathologic diagnosis and clinicopa thologic diagnosis was 81.3%.
Diagnosis ; Erythema Induratum ; Humans ; Incidence ; Korea ; Lupus Vulgaris ; Male ; Outpatients ; Seasons ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

We investigated the distribution of S-100 protein positive dendritic cells in the skin lesions with tuberculoid sturcture. For this study, we selected the paraffin blocks of biopsied specimens with the characteristic histopathology of lupus vulgaris (5cases), tubereulosis verrucosa cutis (1 case), lupus milaris disseminatus faciei (4 cases), and erythema induratum (7 cases). The cells were identified by immunohistochemical demonstration in paraffin sections. The results were as follows: 1. S-100 protein positive dendritic cells were regularly visualized in all lesions examined. 2. S-100 protein positive dendritic cells appeared usually between the lymphohistiocytic infiltrates around the tuberculoid granulomas in contrast to the cells of monocyte-macrophage system which were within the granulomas. And they appeared occasionally (e.g. in a case of lupus vulgaris) between epitheloid cells in the granulomas. 3. S-100 protein positive dendritic cells were more numerous in the granulomatous lesions which showed the well-formed tuberculoid sturcture. From these results, we suggested the S-100 protein positive dendritic cells act as accessory cells in the pathogenesis of the granulomatous lesions by the delayed type hypersensitivity.
Dendritic Cells* ; Erythema Induratum ; Granuloma ; Hypersensitivity ; Lupus Vulgaris ; Paraffin ; S100 Proteins ; Skin*

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*