Cutaneous tuberculosis and erythema induratum: a retrospective study of 13 cases in France

• Published in: Annales de dermatologie et de vénéréologie 2015-04, Vol.142 (4), p.237-244
• Main Authors: Bilan, P, Sin, C, Wann, A-R, Grossin, M, Courdavault, L, Sigal, M-L, Mahé, E
• Format: Article
• Language: fre
• Subjects: Africa, Northern - ethnology; Aged; Antitubercular Agents - therapeutic use; Bacteriological Techniques; Delayed Diagnosis; Diagnosis, Differential; Erythema Induratum - diagnosis; Erythema Induratum - drug therapy; Erythema Induratum - epidemiology; Erythema Nodosum - diagnosis; Female; France - epidemiology; Humans; Male; Middle Aged; Portugal - ethnology; Retrospective Studies; Risk Factors; Skin Ulcer - etiology; Tuberculosis, Cutaneous - diagnosis; Tuberculosis, Cutaneous - drug therapy; Tuberculosis, Cutaneous - epidemiology
• ISSN: 0151-9638
• DOI: 10.1016/j.annder.2015.01.015

Tuberculosis is the most common mycobacterial disease in the world. The cutaneous form is rare in low endemic countries. The occurrence of several cutaneous tuberculosis cases in our dermatology department during 2011-2012 led us to investigate whether there was a resurgence of cutaneous tuberculosis in France. The aim was to analyse changes in cutaneous tuberculosis and the related clinical, microbiological and therapeutic data. We conducted a retrospective study in our hospital between 2005 and 2012 by querying the PMSI database (code: A 18.4). Epidemiological, clinical, paraclinical and therapeutic data were collected. Erythema induratum was regarded as a variety of cutaneous tuberculosis. Thirteen patients presented cutaneous tuberculosis between 2005 and 2012. The most frequent clinical forms were erythema induratum of Bazin (n=6) and scrofuloderma (n=3). Microbiological evidence was provided in only 4 cases. Diagnosis is difficult due to the varied clinical forms and to the relatively high frequency of paucibacillary forms. Further, the set of additional examinations is non-specific. In some cases, it is only therapeutic tests that allow diagnosis to be made. The place of new diagnostic tools must be clarified and a universally acceptable definition of erythema induratum devised.