What is the Inductive (Compacted) Erythema of Bazin?
Inductive (compacted) erythema of Bazin – often develops against the background of the patient’s tuberculosis process, one of its forms (pulmonary tuberculosis, lymph nodes, scrofuloderma, etc.). More often young women (16-40 years old) are ill. A significant role can be played by concomitant diseases associated with circulatory disorders, as well as cooling of the lower extremities, labor associated with prolonged stay on the legs. Exacerbation of the disease in the cold season is characteristic.
Symptoms of Inductive (Compacted) Erythema of Bazin
Clinical manifestations are the appearance of deep, dense, slowly increasing nodes or common flat infiltrates of different sizes. These nodes (from 2 to 10) are located deep in the skin and subcutaneous tissue, slightly painful when palpated. They are located mainly on the legs, hips, arms, buttocks, more often symmetrically.
Sometimes the mucous membranes of the oral cavity and nasopharynx are affected. Having developed to maturity (after a few weeks or months), the nodes undergo reverse development. In their place remain ring-shaped atrophy and pigmentation. Sometimes foci can merge with each other and melt with the formation of fistulas. These ulcerations are painless, with ragged edges and covered with dirty gray granulations. The ulcerative form of inductive erythema is called the Getchinson form, as described by Hetchinson.
In place of the healed ulcers, sunken pigmented scars remain. Untreated disease can last a very long time (months or years). With good immunity, this form of skin tuberculosis develops as an acutely reactive form of inflammation, therefore tuberculin tests are positive in 60-70% of patients.
Diagnosis of Inductive (Compacted) Erythema of Bazin
When making a diagnosis, clinical and histological data are taken into account.
Differential diagnosis is carried out with erythema nodosum and scrofuloderma, if it is located on the legs. Erythema nodosum is characterized by severe inflammation, pain, fever, infrequent relapses, it does not ulcerate, there are no foci of tuberculosis in the patient’s body, tuberculin tests are negative. With scrofuloderma, the nodes are soft, the edges of the ulcers are scout-like, there are fistulous passages.
Treatment of Inductive (Compacted) Erythema of Bazin
General treatment for tuberculosis is indicated. Ultraviolet irradiation, good nutrition (protein, fatty, fortified foods) are prescribed. Ulcers are treated with zinc-gelatin dressings, which are applied to the affected area in the form of a zinc-gelatin “boot” and left for 3-4 weeks.
Prevention of Inductive (Compacted) Erythema of Bazin
Prevention of exacerbations consists of the treatment of vascular pathologies, preservation of the extremities from dampness and hypothermia, as well as from prolonged overwork.