Premium
(9) Phlebitic tuberculid, a new tuberculid?
Author(s) -
Parker Susan C.,
McGibbon D.H.
Publication year - 1987
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1987.tb12027.x
Subject(s) - langhans giant cell , medicine , tuberculosis , mantoux test , pathology , immune system , vasculitis , dermatology , immunology , tuberculin , disease
Currently recognized tuberculids are papulonecrotic tuberculid, erythema induratum and lichen scrofulosorum. We describe two cases of what appears to be a hitherto undescribed tuberculid. Two fit young Oriental women presented with relapsing small nodules on the shins which cleared spontaneously without scarring. The Mantoux test was strongly positive. Histology showed a granulomatous phlebitis with Langhans giant cells but without panniculitis or necrosis. No tubercle bacilli were grown from the skin lesions but there was culture‐proven tuberculosis elsewhere (in the lung and cervical nodes, respectively). The eruption ceased with anti‐tuberculous chemotherapy. These two cases therefore fall within the definition of a tuberculid, yet resemble neither clinically nor histologically any of the three currently recognized forms. In the second case, direct immunofluorescence of the skin lesions showed dermal perivascular deposits of IgM, C 3 and fibrin, thus suggesting an immune complex‐mediated vasculitis, although no immune complexes were detected in the serum, and complement levels were normal. We would, therefore, suggest that these two cases represent a phlebitic tuberculid, possibly with an immune complex‐mediated aetiology.