Clinical Case Vignettes

Recurrent painful panniculitis: Erythema induratum

Sham Santhanam^1*, Susie Samuel²

Author Affiliations

^{1, 2} Global Hospitals, Chennai, India

*Correspondence: Dr. Sham S

itsdrsham@gmail.com

IJRCI. 2015;3(1):V3

Received: 6 April 2015, Accepted: 7 April 2015, Published: 21 April 2015

© IJRCI

Erythema induratum is the presentation of mixed septal and lobular granulomatous panniculitis, with or without vasculitis. It usually affects females in their 3^rd to 4^th decade and has a predilection for calf muscle area. The disease appears as recurrent, painful, refractory lesions, which may (Bazin’s type) or may not be (Whitfield’s type) associated with tuberculosis. The figure 1 shows the development of painful nodules with ulceration on the posterior aspect of leg (calf muscle region) in a 32-year-old lactating female. Findings of skin biopsy (Fig.2) were also consistent for erythema induratum (nodular vasculitis). Additional workup did not indicate any other conditions including latent tuberculosis.^{1, 2}

Fig 1: Healed lesions on the posterior aspect of leg

Fig 2: Skin biopsy (subcutaneous fat): a- Inflammation of fat lobules;

b- Inflammation of septae; c- Inflammation of vessel walls

Competing interests

The authors declare that they have no competing interests.

References

1. Gilchrist H, Patterson JW. Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management. Dermatol Ther. 2010 Jul-Aug;23(4):320-7

2. C. Nirmala and A.H. Nagarajappa. Erythema induratum - A type of cutaneous tuberculosis. Indian J Tuberc 2010; 57:160-164.