Tuberkulides A18.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Tuberculid; Tuberculide

History
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Darier 1896

Definition
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Very rare abacterial eruption as"Id reaction" of the skin (today an outdated term) to tuberculoantigenic material. Allergic-hyperergic reaction of the organism. The criteria for the classification as tuberculoid are:

  • Organ tuberculosis that has been through or simultaneously manifests itself
  • Typical macro- or micromorphological substrate
  • Strong positive intradermal tuberculin test
  • Healing after antituberculosis therapy.

Classification
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The following clinical pictures are etiopathogenetically assigned to the term "tuberculosis":

Etiopathogenesis
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Probably an immunological reaction of the type III immune complex type or type IV late type according to Coombs and Gell. Here, haematogenically scattered antigens of the mycobacteria induce a protracted inflammation in the skin. Frequently, these patients have active organ tuberculosis without anatomical relation to the tuberculi. Typically, cultural cultivations from lesional tissue are negative!

Clinical features
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Laboratory
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Pathogen not culturally detectable.

Histology
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Partly tuberculoid granulomas, partly signs of leukocytoclastic vasculitis without pathogen detection.

Therapy
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In case of detection of tuberculosis, tuberculostatic therapy corresponding to tuberculosis cutis luposa. If necessary, short-term mild creams or ointments containing glucocorticoids externally.

Literature
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  1. Chen Q et al (2019) Cutaneous tuberculosis: A great imitator. Clin Dermatol 37:192-199.
  2. Connors WJ det al.Program-wide review and follow-up of erythema Induratum of Bazin andtuberculosis-associated ocular inflammation management in a TB low-incidencesetting: need for improved treatment candidate selection, therapy standardization, and care collaboration.Infect Dis 19:97.
  3. Darier J (1896) Des tuberculides cutanèes. Ann Derm Syph 7: 1431-1436

  4. Pramatarov K et al (1991) Papulonecrotic tuberculide case report. Z Hautkr 67: 62-64

  5. Thappa DM et al (2003) Tuberculid in a child: transformation from papulonecrotic to lichen scrofulosorum. Pediatric Dermatol 20: 91-93

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020