Tuberkulides A18.4

Darier 1896

The term tuberculid is a historical term under which a series of abacterial reactions (so-called"Id reaction"of the skin/now an obsolete term) to tuberculoantigenic material was summarized. The criteria for classification as a tuberculid are still valid today:

• History or simultaneous manifestation of organ tuberculosis.
• Typical macro- or micromorphological substrate
• Strongly positive intracutaneous tuberculin test
• Healing after antituberculous therapy.

Today, the following clinical pictures are assigned to the term "tuberculid":

• Papulonecrotic tuberculid (Folliculitis de Barthélemy)
• Lichenoid skin tuberculosis
• Erythema induratum (Bazin/syn. nodular vasculitis).

An immunological reaction of the type III immune complex type or type IV late type according to Coombs and Gell is probably present. In this case, hematogenously spread antigens of mycobacteria in the skin induce a protracted inflammation. These patients often have active organ tuberculosis without an anatomical relationship to the tuberculides. Typically, cultural cultures from lesional tissue are negative! It is true that the tuberculides heal under antituberculous therapy. However, the anti-inflammatory effect of antibiotics must also be taken into account.

S. under:

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

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