Mycobacterial subcutaneous arteritis

Rodrigues, Consuelo Junqueira; Campos, Fernando Peixoto Ferraz de; Furtado-Mendonça, Lais Lage; Pereira, Rosa Maria Rodrigues; Langer, Berilo; Diament, Jayme; Oliveira, Ricardo Manoel de; Cossermelli, Wilson

doi:10.1590/S0036-46651990000500006

Abstracts

The authors report three patients with subcutaneous erythematous nodules in different phases of development, inespecific systemic symptoms, positive PPD test, and normal chest X-rays. The histopathological study of the older nodules showed a granulomatous arteritis with a few acid-fast bacilli in the vascular wall. The nodules at an early phase showed an inespecific panniculitis with some acid-fast bacilli in apparently normal cutaneous vessels. These findings suggest that the mycobacterium has a vascular tropism and may cause a primary granulomatous arteritis.

Erythema induratum Bazin; Erythema nodosum; Vasculitis

Os autores descrevem três casos de pacientes com nódulos subcutâneos em diferentes fases de evolução, com sintomas sistêmicos inespe-cíficos, PPD positivo e raio-X de tórax normal. O estudo anátomo-patológico dos nódulos antigos mostrou arterite granulomatosa e com raros bacilos álcool-ácido resistentes na parede vascular; os nódulos recentes mostraram paniculite inespecífica com alguns bacilos álcool-ácido resistentes na parede de vasos cutâneos aparentemente normais. Esses achados sugerem que a micobactéria tem um tropismo vascular e pode causar arterite granulomatosa.

ORIGINAL ARTICLES

Mycobacterial subcutaneous arteritis

Arterite subcutânea por micobactéria

Consuelo Junqueira Rodrigues; Fernando Peixoto Ferraz de Campos; Lais Lage Furtado-Mendonça; Rosa Maria Rodrigues Pereira; Berilo Langer; Jayme Diament; Ricardo Manoel de Oliveira; Wilson Cossermelli

From the Laboratory of Investigation in Experimental Therapeutics and Laboratory of Investigation in Rheumatology, University of São Paulo, School of Medicine, São Paulo, BRASIL

^{Address for correspondence} Address for correspondence: Dra. Consuelo Junqueira Rodrigues Faculdade de Medicina da Universidade de São Paulo, Laboratório de Reumatologia Av. Dr. Arnaldo, 455 CEP 01246 São Paulo, SP, Brasil

SUMMARY

The authors report three patients with subcutaneous erythematous nodules in different phases of development, inespecific systemic symptoms, positive PPD test, and normal chest X-rays. The histopathological study of the older nodules showed a granulomatous arteritis with a few acid-fast bacilli in the vascular wall. The nodules at an early phase showed an inespecific panniculitis with some acid-fast bacilli in apparently normal cutaneous vessels. These findings suggest that the mycobacterium has a vascular tropism and may cause a primary granulomatous arteritis.

Key words: Erythema induratum Bazin; Erythema nodosum; Vasculitis.

RESUMO

Os autores descrevem três casos de pacientes com nódulos subcutâneos em diferentes fases de evolução, com sintomas sistêmicos inespe-cíficos, PPD positivo e raio-X de tórax normal. O estudo anátomo-patológico dos nódulos antigos mostrou arterite granulomatosa e com raros bacilos álcool-ácido resistentes na parede vascular; os nódulos recentes mostraram paniculite inespecífica com alguns bacilos álcool-ácido resistentes na parede de vasos cutâneos aparentemente normais. Esses achados sugerem que a micobactéria tem um tropismo vascular e pode causar arterite granulomatosa.

Full text available only in PDF format.

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ACKNOWLEDGEMENTS

Maria de Fátima de Almeida and Noemi Nosomi Taniwaki are acknowledged for technical assistance and Yukie Umeki for typing this manuscript.

Recebido para publicação em 16/2/1990.

1. ANDERSEN, S.C. Erythema induratum Bazin treated with isoniazid. Acta Derm.-vener. (Stockh.), 50: 65-68, 1970.
2. CORUH, G. & MACDOUGALL, A.C. Untreated lepromatous leprosy: histopathological findings in cutaneous blood vessels. Int. J. Leprosy, 47: 500-511, 1979.
3. EBERHARTINGER, C. Das Problem des Erythema induratum Bazin. Arch. klin. exp. Derm., 217: 196-254, 1963.
4. FAN, P.T.; DAVIS, J.A.; SOMER, T.; KAPLAN, L. & BLUESTONE, R. A clinical approach to systemic vasculitis. Semin. Arthr. Rheum., 9: 248-304, 1980.
5. FINE, R.M. & MELTZER, H.D. Chronic erythema nodosum. Arch. Derm., 100: 33-38, 1969.
6. FORSTROM, L. & HANNUKSELA, M. Antituberculous treatment of erythema induratum Bazin. Acta Derm.-vener. (Stockh.), 50: 143-147, 1970.
7. FORSTROM, L. & WINKELMANN, R.K. Granulomatous panniculitis in erythema nodosum. Arch. Derm., 111: 335-340, 1975.
8. GOETLE, D.K.; JACOBSON, K.W. & DOTY, R.D. Primary inoculation tuberculosis of the skin. Arch. Derm., 114: 567-569, 1978.
9. ITO, K. Reconsidering the classical entity of erythema induratum in the age of modern therapy. Bull. pharm. Res. Inst., 34: 24-28, 1961.
10. JOLLIFFE, D.S. Leprosy reactional states and their treatment. (Review). Brit. J. Derm., 97: 345-352, 1977.
11. KATO, L. & GOZSY, B. Studies on the physiopathology of experimental murine leprosy. Reticuloendothelial, capillary and mast cell response A review. Rev. canad. Biol., 23: 217-226, 1964.
12. LEVER, W.F. & SCHAUMBURG-LEVER, G. Histopathology of the skin. 6th ed. Philadelphia, JB Lippincott Company, 1983. p. 245-250.
13. MONTGOMERY, H.; O'LEARY, P.A. & BARKER, N.W. Nodular vascular diseases of the legs. J. Amer. med. Ass., 128: 335-341, 1945.
14. REA, T.H. & LEVAN, N.E. Lucio's phenomenon and diffuse nonnodular lepromatous leprosy. Arch. Derm., 114: 1023-1028, 1978.
15. SCHNEIDER, W. & UNDEUTSCH, W. Vasculitides des subcutaneum Feltgewebes. Arch. klin. exp. Derm., 221: 600-610, 1965.
16. TELFORD, E.D. Lesions of the skin and subcutaneous tissue in diseases of the peripheral circulation. Arch. Derm. Syph. (Chic), 36: 952-963, 1937.
17. TUNDER, R.M.; RENYA, G.S. & BENSCH, K. Mycobacterial coronary arteritis in a heart transplant recipient. Hum. Path., 17: 1072-1074, 1986.
18. VILANOVA, X. & PINOL AGUADE, J. Subacute nodular migratory panniculitis. Brit. J. Derm., 71: 45-50, 1959.

Address for correspondence:

Dra. Consuelo Junqueira Rodrigues

Faculdade de Medicina da Universidade de São Paulo, Laboratório de Reumatologia

Av. Dr. Arnaldo, 455

CEP 01246 São Paulo, SP, Brasil

Publication Dates

Publication in this collection
12 Sept 2006
Date of issue
Oct 1990

History

Received
16 Feb 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANDERSEN, S.C. Erythema induratum Bazin treated with isoniazid. Acta Derm.-vener. (Stockh.), 50: 65-68, 1970.

[2] 2. CORUH, G. & MACDOUGALL, A.C. Untreated lepromatous leprosy: histopathological findings in cutaneous blood vessels. Int. J. Leprosy, 47: 500-511, 1979.

[3] 3. EBERHARTINGER, C. Das Problem des Erythema induratum Bazin. Arch. klin. exp. Derm., 217: 196-254, 1963.

[4] 4. FAN, P.T.; DAVIS, J.A.; SOMER, T.; KAPLAN, L. & BLUESTONE, R. A clinical approach to systemic vasculitis. Semin. Arthr. Rheum., 9: 248-304, 1980.

[5] 5. FINE, R.M. & MELTZER, H.D. Chronic erythema nodosum. Arch. Derm., 100: 33-38, 1969.

[6] 6. FORSTROM, L. & HANNUKSELA, M. Antituberculous treatment of erythema induratum Bazin. Acta Derm.-vener. (Stockh.), 50: 143-147, 1970.

[7] 7. FORSTROM, L. & WINKELMANN, R.K. Granulomatous panniculitis in erythema nodosum. Arch. Derm., 111: 335-340, 1975.

[8] 8. GOETLE, D.K.; JACOBSON, K.W. & DOTY, R.D. Primary inoculation tuberculosis of the skin. Arch. Derm., 114: 567-569, 1978.

[9] 9. ITO, K. Reconsidering the classical entity of erythema induratum in the age of modern therapy. Bull. pharm. Res. Inst., 34: 24-28, 1961.

[10] 10. JOLLIFFE, D.S. Leprosy reactional states and their treatment. (Review). Brit. J. Derm., 97: 345-352, 1977.

[11] 11. KATO, L. & GOZSY, B. Studies on the physiopathology of experimental murine leprosy. Reticuloendothelial, capillary and mast cell response A review. Rev. canad. Biol., 23: 217-226, 1964.

[12] 12. LEVER, W.F. & SCHAUMBURG-LEVER, G. Histopathology of the skin. 6th ed. Philadelphia, JB Lippincott Company, 1983. p. 245-250.

[13] 13. MONTGOMERY, H.; O'LEARY, P.A. & BARKER, N.W. Nodular vascular diseases of the legs. J. Amer. med. Ass., 128: 335-341, 1945.

[14] 14. REA, T.H. & LEVAN, N.E. Lucio's phenomenon and diffuse nonnodular lepromatous leprosy. Arch. Derm., 114: 1023-1028, 1978.

[15] 15. SCHNEIDER, W. & UNDEUTSCH, W. Vasculitides des subcutaneum Feltgewebes. Arch. klin. exp. Derm., 221: 600-610, 1965.

[16] 16. TELFORD, E.D. Lesions of the skin and subcutaneous tissue in diseases of the peripheral circulation. Arch. Derm. Syph. (Chic), 36: 952-963, 1937.

[17] 17. TUNDER, R.M.; RENYA, G.S. & BENSCH, K. Mycobacterial coronary arteritis in a heart transplant recipient. Hum. Path., 17: 1072-1074, 1986.

[18] 18. VILANOVA, X. & PINOL AGUADE, J. Subacute nodular migratory panniculitis. Brit. J. Derm., 71: 45-50, 1959.