Abstract Number: 87

The protean manifestations of tuberculosis: concurrent erythema of Bazin and Poncet’s disease

F.P.-C. Chiu 1, J.F. Dayrit2

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Individuals with active tuberculosis can present to derma- tologists with diverse infective and reactive manifestations that may lead to delay in diagnosis and initiation of effec- tive treatment. We describe a 25-year-old Filipino male who was seen initially in a rheumatology clinic with a 2.5- month history of joint pains as well as bilateral violaceous nodules on his lower limbs and ankle oedema. A clinical diagnosis of erythema nodosum was made but there was no clinical improvement following treatment with non- steroidal anti-inflammatory drugs and prednisone. On der- matologist review, multiple violaceous poorly defined nod- ules were observed across the posterior aspect of both lower legs with atrophic scarring and post-inflammatory hyperpigmentation. Scattered erythematous papules over- lying bilateral pitting oedema of his ankles were also evi- dent. Investigations revealed an elevated ESR, CRP, and a positive Mantoux test. A skin biopsy revealed lobular pan- niculitis with vasculitis, consistent with erythema indura- tum of Bazin. The joint symptoms were attributed to tuberculous rheumatism, also known as Poncet’s disease, a non-suppurative reactive arthritis that occurs in people with active tuberculosis. He was managed with 6 months of anti-tuberculous treatment, which completely resolved both his skin and joint symptoms and signs. Given the increasing numbers of migrants to Australia from TB- endemic countries, including the Philippines, ongoing vigi- lance for TB and awareness of its protean clinical manifes- tations is important for all clinicians.