Tuberkulides A18.4

Darier 1896

Very rare abacterial eruption as"Id reaction" of the skin (today an outdated term) to tuberculoantigenic material.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.

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

• Papulonecrotic Tuberculide
• lichenoid skin tubercle
• Erythema nodosum
• Erythema induratum.

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!

S. under:

• Papulonecrotic Tuberculide
• Tuberculosis cutis lichenoides
• Erythema nodosum
• Erythema induratum.

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