title: Mycobacterium tuberculosis infection is associated with the development of erythema nodosum and nodular vasculitis.
abstract: BACKGROUND
  Mycobacterium tuberculosis (MTB) infection has been suggested to contribute to the pathogenesis of erythema nodosum (EN) and nodular vasculitis (NV), the classic forms of panniculitis. However, there is little evidence to demonstrate the presence of MTB in the skin lesions. This study is aimed at evaluating the association between MTB infection and the development of EN and NV in a Chinese population.
  
  
  METHODS
  A total of 107 patients (36 EN, 27 NV, and 44 others) with vasculitis and 40 control cases with other skin diseases were recruited and their skin lesion samples were subjected to real time polymerase chain reaction (PCR) analysis of the IS6110 and mpt64 gene fragments of MTB. Their blood mononuclear cells were tested for MTB antigen-specific IFN-γ responses by QuantiFERON®-TB Gold In-Tube (IT) assays.
  
  
  RESULTS
  PCR analysis revealed that 7/23 (30.4%) and 7/18 (38.9%) of the EN and NV samples were positive for the IS6110 DNA, respectively, which were significantly higher than 3/34 (8.8%) of other vasculitis (OV) and 3/40 (7.5%) of the control samples (p<0.05). The nested Real-Time PCR assay indicated that 6/7 (86%) of the IS6110-positive EN samples, all of the IS6110-positive NV and control samples, but only 1/3 of the IS6110-positive OV samples, were positive for the mpt64 gene. Similarly, 19/32 (59.4%) of the EN patients, 20/26 (76.9%) of the NV patients, and 17/36 (47.2%) of the OV patients were positive for MTB antigen-specific IFN-γ responses, which were significantly higher than 6/40 (15%) of the controls (p<0.05).
  
  
  CONCLUSIONS
  Our data strongly suggest that MTB infection and active TB are associated with the development of NV and EN in Chinese.
authors: Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Sheng'an
authors: S
authors: Chen
authors: Jiazhen
authors: J
authors: Chen
authors: Lianjun
authors: L
authors: Chen
authors: Qiao'an
authors: Q
authors: Zhang
authors: Xiaoqun
authors: X
authors: Luo
authors: Wenhong
authors: W
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000235:genetics / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D004893:Erythema Nodosum / Q000382:microbiology*; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D014382:Tuberculosis, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D014657:Vasculitis / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; C510537:MPT64 protein, Mycobacterium tuberculosis
references: Chin Med J (Engl). 2010 Oct;123(20):2786-91
references: 21034583
references: Int J Tuberc Lung Dis. 2011 Feb;15(2):174-8, i
references: 21219677
references: Semin Cutan Med Surg. 2007 Jun;26(2):126-30
references: 17544965
references: Arthritis Rheum. 2000 Mar;43(3):584-92
references: 10728752
references: Br J Dermatol. 2007 Dec;157(6):1293-4
references: 17927790
references: BMC Public Health. 2012 Oct 19;12:885
references: 23083352
references: J Am Acad Dermatol. 2008 Nov;59(5):839-51
references: 19119100
references: J Clin Microbiol. 2008 May;46(5):1708-15
references: 18337390
references: Int J Dermatol. 1999 Feb;38(2):122-7
references: 10192161
references: Int J Dermatol. 2002 Mar;41(3):173-5
references: 12010345
references: Int J Dermatol. 1996 Nov;35(11):802-8
references: 8915735
references: Arch Dermatol. 1997 Apr;133(4):457-62
references: 9126009
references: Clin Vaccine Immunol. 2010 Dec;17(12):1985-90
references: 20943878
references: Semin Cutan Med Surg. 2007 Jun;26(2):114-25
references: 17544964
references: PLoS Med. 2009 Dec;6(12):e1000199
references: 20027210
references: Scand J Infect Dis. 2004;36(6-7):424-7
references: 15307561
references: Eur J Dermatol. 2010 Nov-Dec;20(6):773-7
references: 21030339
references: J Dtsch Dermatol Ges. 2004 Mar;2(3):206-14; quiz 215
references: 16281639
references: Br Med J. 1968 Oct 26;4(5625):223-4
references: 4300767
references: Microbiology (Reading). 2009 Jul;155(Pt 7):2384-2389
references: 19389783
references: Indian J Exp Biol. 2009 Jun;47(6):463-8
references: 19634712
references: PLoS One. 2006 Dec 20;1:e43
references: 17183672
references: PLoS One. 2012;7(3):e32652
references: 22427859
references: J Clin Microbiol. 2003 Oct;41(10):4565-72
references: 14532183
references: PLoS One. 2010 Aug 19;5(8):e12287
references: 20808814
references: Ann Intern Med. 2008 Aug 5;149(3):177-84
references: 18593687
references: BMC Public Health. 2012 Dec 23;12:1110
references: 23259484
references: Enferm Infecc Microbiol Clin. 2010 Apr;28(4):245-52
references: 19783328
references: Indian J Dermatol. 2012 Mar;57(2):114-7
references: 22615507
references: J Med Assoc Thai. 2003 Dec;86(12):1095-100
references: 14971515
references: Exp Ther Med. 2012 Nov;4(5):949-953
references: 23226754
references: J Dermatol. 2004 Jan;31(1):66-8
references: 14739509
references: PLoS Pathog. 2008 Nov;4(11):e1000204
references: 19002241
references: Indian J Dermatol Venereol Leprol. 2001 Nov-Dec;67(6):287-9
references: 17664778
references: Dermatol Ther. 2010 Jul-Aug;23(4):320-7
references: 20666819
references: J Clin Pathol. 1996 Apr;49(4):290-4
references: 8655703