Bazin hard erythema

Bazin hard erythema introduction Hardy erythema (erythemainduratum), also known as indurated erythema, or Bazin disease, or tuberculosis cutisindurativa, is a deep blood-borne skin tuberculosis. There is another hard erythema in the literature called Whitfield Hard Erythema. It is considered to be a nodular vasculitis. basic knowledge The proportion of illness: 0.005% Susceptible people: good for young women Mode of infection: non-infectious Complications: vasculitis

Bazin hard erythema cause

(1) Causes of the disease

The cause of scleroderma is unknown. Most of the young women aged 16 to 25 years have flexion on the calf and are prone to develop in winter. Therefore, the disease is related to age , gender, cold and blood circulation . Patients are often accompanied by tuberculosis , lymphatic tuberculosis or other organ tuberculosis . Hard erythema has tuberculous infiltration, often with caseous necrosis, has been considered a skin tuberculosis , but can not find tuberculosis . Some scholars believe that hard erythema is a kind of subcutaneous arteriovenous vasculitis, causing fat necrosis. However, it is believed that the onset of hard erythema is due to the release of Mycobacterium tuberculosis from the blood vessels, initially a local allergic reaction followed by a delayed type hypersensitivity reaction . Therefore, the disease may be a skin immune response that occurs due to a variety of factors that stimulate the body's own immune system .

(two) pathogenesis

The current pathogenesis is not very clear. Recently, some authors believe that the primary disease of hard erythema becomes inflammation of the subcutaneous arterioles and veins. According to Schneider and Undeutsch, any fat necrosis that occurs after vascular damage can develop into tuberculosis. which performed.

Bazin hard erythema prevention

The principle of prevention: mainly to mobilize the masses, vigorously promote the prevention and treatment of tuberculosis, and conduct regular health checks. Do early detection and early treatment.

Bazin hard erythema complications Complications vasculitis

There are usually no special complications.

Bazin hard erythema symptoms common symptoms virtual fire tension subcutaneous nodules

In the past, most of the history of tuberculosis or visceral tuberculosis was more common in young women. The symmetry was distributed in the lower and middle flexion of the lower leg (Fig. 1). In the case of invading the thigh or other parts, it occurred slowly and mostly in spring and autumn. The rash begins with the subcutaneous nodules of the tough activity of peas or broad beans, which gradually increase from walnut to chicken eggs. The epidermis is tense due to pressure, and the color changes from flushing to dark red or blue, and the infiltration is obvious. Nodules can be changed for a long time, and can be gradually absorbed and cured, or softened and broken, forming a deep and non-plastic ulcer. There is a thin yellowish cheese-like pus. The ulcer is a typical tuberculous ulcer with a thin edge and a chisel. After the recovery, there is atrophic scar and hyperpigmentation, and there is a slight tenderness. The standing pain or excessive pain can be aggravated. The moderate dilution of tuberculin (1:10000) is positive, and the low dilution (1) : 1000) is weakly positive or negative.

Bazin hard erythema check

Histopathology: epidermis atrophy and thinning, infiltration mainly in the deep dermis, even subcutaneous tissue, infiltration by most typical and atypical epithelioid cells and lymphocytes, and a small number of plasma cells, which can be seen in a few Langhan Giant cells, vascular changes are very significant, for vasculitis changes, vascular endothelial cells swelling, degeneration or hyperplasia, thrombosis, luminal occlusion, may be associated with varying degrees of degeneration and necrosis of fat cells.

Bazin hard erythema diagnosis and identification

Diagnostic criteria

More common in young women, the symmetry is distributed in the lower and lower flexion of the lower leg, and there is invasion of the thigh or other parts. After slow, mostly occurs in spring and autumn, the rash starts from the tough nodules of the pea or broad bean. Gradually increase, up to the walnut to chicken eggs, the epidermis is stressed due to pressure, the color changes from flushing to dark red or blue, infiltration, there is a history of tuberculosis or with visceral tuberculosis, histopathology: epidermal atrophy and thinning Invasion is mainly in the deep dermis, even up to the subcutaneous tissue. The infiltration is composed of most typical and atypical epithelioid cells and lymphocytes, and there are a few plasma cells, in which a few Langhans giant cells can be seen. Very significant, for vasculitis changes, vascular endothelial cell swelling, degeneration or hyperplasia, thrombosis, luminal occlusion, may be associated with different degrees of degeneration and necrosis of fat cells, can be diagnosed.

TCM pathogenesis and syndrome differentiation:

1. Pathogenesis Chinese medicine believes that this disease is mostly due to weak qi deficiency, virtual fire internal movement, consumption of blood, phlegm and dampness, and the accumulation of skin.

2. Dialectical analysis showed that the skin lesions were dark red nodules, or long-term unhealed after the collapse, accompanied by fatigue, poor anorexia, thirst for not drinking, sometimes irritability and irritability, pale tongue or red tongue, thin pulse Or Shen Xian, dialectical is a weak qi deficiency, phlegm dampness, qi stagnation and blood stasis.

Differential diagnosis

1. Nodular erythema is more common in the calf extension, the incidence is more acute, the affected part of the pain, often accompanied by joint pain, nodules are bright red and not broken.

2. Nodular panniculitis is also common in the calf, but it can also be seen in the waist and hips and the thighs, upper limbs, etc., after the nodule collapses, it can flow out of yellow oily liquid, often in a recurrence, accompanied by each onset. Fever, general malaise and joint pain, histopathological findings showed fatty lobules, and a large number of neutrophil infiltration.

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