A Cutaneous Clue to Prolonged Fever: Erythema Induratum of Bazin in a Tuberculosis-Endemic Region.
Erythema induratum of Bazin (EIB) is a rare form of cutaneous tuberculosis characterised by recurrent nodular lesions, predominantly affecting the lower extremities. It is considered a hypersensitivity reaction to Mycobacterium tuberculosis rather than a direct infection, hence the term "tuberculid". Due to its nonspecific clinical presentation, it often mimics other dermatological and systemic conditions, leading to diagnostic challenges. We report a case of a 40-year-old woman presenting with prolonged low-grade fever, weight loss, and multiple tender nodular lesions over the lower limbs and forearms. Laboratory evaluation revealed anaemia of chronic disease and elevated inflammatory markers, while autoimmune and infectious workup was negative. Histopathological examination demonstrated lobular panniculitis with lymphohistiocytic infiltrates and granulomatous inflammation along with vasculitis, consistent with EIB. The patient was initiated on anti-tubercular therapy, resulting in complete resolution of symptoms and lesions. This case highlights the importance of considering cutaneous tuberculosis in patients with persistent nodular lesions, particularly in endemic regions, and underscores the diagnostic value of histopathology.