PMC8604635_01
Clinical image on day 1. Erythematous to violaceous, well-defined, deep-seated nodules and macules mostly over the distal-third of the lower legs. Some of the lesions showed superficial ulcer covered with crusts and scales.
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Deep atrophy of the skin resulted in asymmetrical lower leg shape without movement disability (Figure 1). Varicose veins were observed on popliteal fossa (Figure 1). Some skin lesions showed superficial ulcers on deep skin atrophy covered with crusts and scales (Figure 1).
Histopathology of erythema induratum of Bazin. Skin biopsy shows lobular panniculitis (A), granulomatous inflammation consisted of caseous necrosis (red circle), epithelioid cell proliferation, and multinucleated giant cells (red arrow) (B). (Hematoxylin-eosin stain; original magnification, 200x (A), and 100x (B), respectively).
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Histopathological examination showed lobular panniculitis (Figure 2A) without vasculitis and granulomatous inflammation (Figure 2B) which consisted of caseous necrosis (red circle), epithelioid cells, and multinucleated giant cells (red arrow).
Nuclear 99mTc-ethambutol scintigraphy shows increased pathological radioactivity imaging in the distal-third of the left lower leg at 4 hours post-radiopharmaceuticals injection.
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Nuclear 99mTc-ethambutol scintigraphy was positive for tuberculosis infection in the one-third distal portion of the left lower leg (Figure 3).
Clinical image after 6 months of anti-tuberculosis therapy. Cutaneous nodules started to regress, ulcer and crusts healed with atrophic scar and post-inflammatory hyperpigmentation.
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After 6 months of treatment, the nodules regressed and healed, and no new skin lesions occurred (Figure 4).