Korean J Dermatol.  2018 Mar;56(3):206-209.

A Case of Drastically Aggravated Erythema Induratum due to Co-existing Peripheral Arterial Occlusive Disease

• Kang JN
• Seol JE
• Kim DH
• Park SH
• Kim H

Abstract

A 72-year-old woman presented with recurrent painful erythematous nodules and ulcers on both legs. Latent tuberculosis was proven by a positive interferon-gamma release assay, and a histopathology examination revealed septolobular panniculitis with vasculitis. The initial diagnosis was erythema induratum associated with tuberculosis, but the leg ulcers became worse despite anti-tuberculosis medication and wound dressing. Computed tomography angiography showed occlusion of the superficial femoral and popliteal arteries bilaterally, supporting that the vascular event contributes to the ulcers according to the vascular territories. Under the diagnosis of peripheral arterial occlusive disease, she was treated with percutaneous transluminal angioplasty and antiplatelet medication. The skin ulcers were resolved. Elderly patients with erythema induratum have a risk of coincidental peripheral arterial occlusive disease, therefore dermatologists should be aware of the possibility of underlying vascular disease, so even minor trauma like skin biopsy can evoke serious condition shown in this patient. Here, we report a case of drastically aggravated erythema induratum due to co-existing peripheral arterial occlusive disease, which resolved with vascular intervention after not responding to antituberculosis medication.

Keyword

Erythema induratum; Latent tuberculosis; Peripheral arterial occlusive disease

MeSH Terms

Aged
Angiography
Angioplasty
Arterial Occlusive Diseases*
Bandages
Biopsy
Diagnosis
Erythema Induratum*
Erythema*
Female
Humans
Interferon-gamma Release Tests
Latent Tuberculosis
Leg
Leg Ulcer
Panniculitis
Popliteal Artery
Skin
Skin Ulcer
Tuberculosis
Ulcer
Vascular Diseases
Vasculitis
Wounds and Injuries