A Case of Tuberculous Granulomatous Panniculitis without Vasculitis.
We report a case of tuberculous granulomatous panniculitis without vasculitis in an 87-year-old female patient with B-cell chronic lymphocytic leukaemia. One month after starting chemotherapy with chlorambucil and prednisone she presented superficial erythematous plaques on the anterior side of the left leg. Three weeks later erythematous painless deep nodules appeared on the left popliteal fossa and on the left thigh. Cutaneous biopsy revealed granulomatous panniculitis without caseation necrosis or vasculitis. Polymerase chain reaction for Mycobacterium tuberculosis revealed positivity in the skin. The final diagnosis was reactivation of latent tuberculosis (TB) induced by deep immunosuppression associated with chemotherapy and haematological disease. Tuberculous granulomatous panniculitis without vasculitis is a rare presentation of cutaneous TB and may be part of the heterogeneous histopathologic spectrum of erythema induratum of Bazin (nodular vasculitis). Our case shows that the diagnosis of cutaneous TB requires the correlation of clinical findings with histopathology and microbiological tests.
Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland.
Yassaman Alipour
YA
Tehrany
Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland.
Laurence
L
Toutous-Trellu
Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland.
Véronique
V
Trombert
Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland.
Jean-Luc
JL
Reny
Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland.
Gürkan
G
Kaya
Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland.
Virginie
V
Prendki
Cutaneous tuberculosis; Granulomatous panniculitis; Immunosuppression