Tuberkulides A18.4

Darier 1896

The term tuberculid is a historical term under which a series of abacterial reactions (so-called"Id reaction"of the skin/now an obsolete term) to tuberculoantigenic material was summarized. The criteria for classification as a tuberculid are still valid today:

• History or simultaneous manifestation of organ tuberculosis.
• Typical macro- or micromorphological substrate
• Strongly positive intracutaneous tuberculin test
• Healing after antituberculous therapy.

The following clinical pictures are assigned to the term "tuberculid" today:

• Papulonecrotic tuberculid (folliculitis de Barthélemy).
• Lichenoid skin tuberculid
• Erythema nodosum
• Erythema induratum (Bazin/syn. nodular vasculitis).

An immunological reaction of the type III immune complex type or type IV late type according to Coombs and Gell is likely. Here, hematogenously scattered antigens of mycobacteria in the skin induce protracted inflammation. Often, these patients are found to have active organ tuberculosis with no anatomic relationship to the tuberculids. Typically, cultural cultures from lesional tissue are negative! Because of the general decline in tuberculosis, further research in this area is nihct.

S. under:

• Papulonecrotic Tuberculide
• Tuberculosis cutis lichenoides
• Erythema nodosum
• Erythema induratum.

1. Chen Q et al (2019) Cutaneous tuberculosis: A great imitator. Clin Dermatol 37:192-199.
2. Connors WJ det al.Program-wide review and follow-up of erythema Induratum of Bazin andtuberculosis-associated ocular inflammation management in a TB low-incidencesetting: need for improved treatment candidate selection, therapy standardization, and care collaboration.Infect Dis 19:97.

3. Darier J (1896) Des tuberculides cutanèes. Ann Derm Syph 7: 1431-1436

4. Pramatarov K et al (1991) Papulonecrotic tuberculide case report. Z Hautkr 67: 62-64

5. Thappa DM et al (2003) Tuberculid in a child: transformation from papulonecrotic to lichen scrofulosorum. Pediatric Dermatol 20: 91-93