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The following is a summary of “Nodular vasculitis – Retrospective study of an uncommon disease in a non-tuberculosis endemic country with focus on treatment modalities and efficacy,” published in the November 2024 issue of Dermatology by Guillet et al. 

Nodular vasculitis (NV), a rare panniculitis affecting middle-aged females, presented as painful, sometimes ulcerated nodules on the lower legs, with erythema induratum Bazin (EIB) being a form associated with cutaneous tuberculin hypersensitivity.  

Researchers conducted a retrospective study to analyze demographic, clinicopathological, laboratory, and treatment outcome data of NV in a non-tuberculosis endemic region.  

They extracted data from the electronic hospital database of the University Hospital Zurich for patients diagnosed with NV, only individuals with a histopathologically confirmed diagnosis of NV and sufficient demographic, treatment, and follow-up information were included.  

The results showed 62 patients with NV, with lower extremities as the most affected site. The disease’s duration ranged from several months to over 20 years. The histopathological analysis revealed lobular panniculitis, with or without vasculitis, and granuloma formation. Tuberculosis association was evaluated using the QuantiFERON test and Mycobacteria PCR, with positive results in 22 of 37 (59%) and 2 of 27 (7.4%) cases, respectively. Comorbidities were present in more than 50% of the patients. Treatment approaches included topical corticosteroids, antitubercular therapy, systemic steroids, and potassium iodide. Nearly 50% of patients experienced relapses despite treatment.  

Investigators concluded the topical steroids, antitubercular therapy, systemic steroids, and potassium iodide demonstrated comparable response rates in treating NV, Tuberculostatic treatment was advised for latent TB, while potent topical steroids and compression stockings were recommended as a first-line treatment due to the high recurrence rate and potential side effects of systemic therapies. 

Source: karger.com/drm/article/doi/10.1159/000542488/916216/Nodular-vasculitis-Retrospective-study-of-an