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Tuberculosis-Associated Erythema Nodosum
Jennifer Laborada1, Philip R Cohen2
1Dermatology, University of California Riverside School of Medicine, Riverside, USA.
Cureus
|January 10, 2022
Summary
Erythema nodosum, a type of panniculitis, can be linked to latent tuberculosis, especially in endemic areas. Prompt diagnosis and evaluation are key for identifying underlying causes like tuberculosis.
Area of Science:
- Dermatology
- Infectious Diseases
- Immunology
Background:
- Erythema nodosum is a form of panniculitis often seen in women aged 18-34.
- While frequently idiopathic, it can be associated with drugs, infections, malignancy, pregnancy, and systemic illnesses.
- The condition presents as sudden-onset, tender, erythematous nodules, typically on the lower extremities.
Observation:
- This case report details a woman from Vietnam, a tuberculosis-endemic country, who presented with EN.
- Her EN was diagnosed as a sequela of latent tuberculosis infection.
- EN typically manifests as sudden-onset, tender, warm, erythematous nodules on the lower extremities.
Findings:
- Studies show a significant association between EN and tuberculosis, especially in endemic regions.
- Tuberculosis-associated EN incidence is reported at 6%, rising to 11% or 21% in cases of secondary or infection-associated EN, respectively.
- Clinical diagnosis of EN is common, but identifying an underlying cause through history and work-up is crucial.
Implications:
- EN evaluation in endemic areas should consider tuberculosis screening.
- Diagnostic tools include tuberculin or QuantiFERON tests, chest roentgenograms, and sputum cultures for acid-fast bacilli.
- Prompt identification of tuberculosis as an underlying cause allows for targeted treatment and management.
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