Erythema induratum of Bazin associated with Addison’s disease

first description

Authors

  • Rodrigo Antonio Brandão Neto Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo
  • Jozélio Freire de Carvalho Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo

Keywords:

Addison disease, Adrenal insufficiency, Tuberculosis, Erythema induratum, Tuberculosis, cutaneous, Doença de Addison, Insuficiência adrenal, Tuberculose, Eritema endurado, Tuberculose cutânea

Abstract

CONTEXT: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison’s disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin) test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison’s disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison’s disease.

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Author Biographies

Rodrigo Antonio Brandão Neto, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo

MD. Attending Physician, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

Jozélio Freire de Carvalho, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo

MD, PhD. Collaborating Professor, Rheumatology Division, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.

References

Winkelmann RK. Panniculitis in connective tissue disease. Arch Dermatol. 1983;119(4):336-44.

Nascimento LV, Rodrigues AG, Carneiro MBX, et al. Tuberculose cutânea no Brasil [Cutaneous tuberculosis in Brazil]. An Bras Derm. 1996;71(Supl. 2): 21-3.

Cho KH, Lee DY, Kim CW. Erythema induratum of Bazin. Int J Derm. 1996;35(11):802-8.

Fernández del Moral R, Ereño C, Arrinda JM, Alvarez de Mon M. Erythema induratum of Bazin and active renal tuberculosis. J Amer Acad Derm. 1994;31(2 Pt 1):288-90.

Förström L, Hannuksela M. Antituberculous treatment of erythema induratum Bazin. Acta Derm-Venereol. 1970;50(2):143-7.

Hassoun PM, Shepherd KE, Flotte TJ, Kazemi H. Erythema induratum and active pulmonary tuberculosis. Amer J Med. 1988;84(4):784-5.

Jacinto SS, Nograles KB. Erythema induratum of Bazin: role of polymerase chain reaction in diagnosis. Int J Derm. 2003;42(5):380-1.

Lebel M, Lassonde M. Erythema induratum of Bazin. J Am Acad Dermatol. 1986;14(5 Pt 1):738-42.

De Silva HG, Goonetilleke AK, De Silva NR, Amarasekera LR, Jayawickrama US. Erythema induratum (of Bazin) in a patient with endometrial tuberculosis. Postgrad Med J. 1988;64(749):242-4.

Michelson HE. Inflammatory nodosa lesions of the lower leg. AMA Arch Derm Syphilol. 1952;66(3):327-32.

Hägg E, Asplund K, Lithner F. Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency. Clin Endocrinol (Oxf ). 1987;26(2):221-6.

Kyriazopoulou V, Parparousi O, Vagenakis AG. Rifampicin-induced adrenal crisis in addisonian patients receiving corticosteroid replacement therapy. J Clin Endocrinol Metab. 1984;59(6):1204-6.

Edwards OM, Courtenay-Evans RJ, Galley JM, Hunter J, Tait AD. Changes in cortisol metabolism following rifampicin therapy. Lancet. 1974;2(7880):548-51.

Fernandes VS, Bisi H, Longatto Filho A, de Camargo RY. Incidencia de adrenalites em material de necropsia [Incidence of adrenalitis in necropsy material] . Rev Hosp Clin Fac Med Univ Sao Paulo. 1991;46(5):219-22.

Vita JA, Silverberg SJ, Goland RS, Austin JH, Knowlton AI. Clinical clues to the cause of Addison’s disease. Am J Med. 1985;78(3):461-6.

Sun ZH, Nomura K, Toraya S, et al. Clinical significance of adrenal computed tomography in Addison’s disease. Endocrinol Jpn. 1992; 39(6):563-9.

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Published

2012-11-11

How to Cite

1.
Brandão Neto RA, Carvalho JF de. Erythema induratum of Bazin associated with Addison’s disease: first description. Sao Paulo Med J [Internet]. 2012 Nov. 11 [cited 2025 Mar. 14];130(6):405-8. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1533

Issue

Section

Case Report