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Cutaneous tuberculosis

What is it cutaneous tuberculosis?

Cutaneous tuberculosis (TB) is essentially an invasion of the skin by Mycobacterial tuberculosis, the same bacteria causing TB of the lungs (pulmonary TUBERCULOSIS). Cutaneous TB is a relatively rare form of extrapulmonary TB (TB infection of other organs and tissues). Even in countries like India and China, where TB still occurs commonly, skin outbreaks are rare (<0.1%).

Types of cutaneous tuberculosis

There are several different types of cutaneous TB. Direct skin infection or mucous membranes from an external source of mycobacteria result in an initial injury called the tubercular chancre. Cankers are firm and shallow. ulcers With a granular base. They appear about 2-4 weeks after the mycobacteria enter through the broken skin. The patient's immune response and the virulence of the mycobacteria determine the type and severity of skin tuberculosis.

Types of cutaneous tuberculosis Characteristics
TB verrucosa skin
  • Occurs after direct inoculation TB on the skin in someone who has previously been infected with mycobacteria
  • It appears as a purple or reddish-brown color. warty increase
  • Injuries most often occur to the knees, elbows, hands, feet, and buttocks.
  • Lesions can persist for years, but can disappear even without treatment.
Vulgar lupus
  • Persistent and progressive form of cutaneous tuberculosis
  • Small, well-defined, reddish-brown lesions with a jelly-like consistency (called apple jelly nodules)
  • Lesions persist for years, leading to disfigurement and sometimes the skin. Cancer
Scrofuloderma
  • Skin lesions result from the direct extension of the underlying TB infection from lymph nodes, bone or joints
  • Often associated with TB of the lungs
  • Firm, painless lesions that eventually ulcerate with a granular base.
  • It can heal even without treatment, but this takes years and leaves unsightly scars
Miliary tuberculosis
  • Chronic Tuberculosis infection that has spread from primary infection (usually in the lungs) to other organs and tissues through the bloodstream
  • Skin lesions are small red spots (about the size of a millet) that turn into ulcers and abscesses.
  • Most likely in immunocompromised patients, p. ex. HIV, AIDS, cancer
  • The patient is generally ill.
  • Forecast is poor (many patients die even if diagnosed and treated)
Tuberculous
  • Generalized exanthema in patients with moderate or high immunity to tuberculosis from previous infection
  • Generally in good health with no identifiable focus of active TB on the skin or elsewhere
  • Erythema induratum (Bazin's disease) occurs as recurrent nodules or lumps on the back of the legs (mainly female) that may ulcerate and scar. It is a kind of nodular vasculitis.
  • The papulonecrotic tuberculid produces cultures of recurrent crusted skin papules on knees, elbows, buttocks, or lower trunk that heal with scars after about 6 weeks.
  • Lichen scrofulosorum is an extender eruption when I was little follicular papules in young people with underlying tuberculosis.
Cutaneous tuberculosis

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Vulgar lupus

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Vulgar lupus

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Erythema induratum

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Miliary cutaneous tuberculosis

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Tuberculosis innovation

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Tuberculosis verrucosa cutis

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Scrofuloderma

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Erythema induratum

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Scrofuloderma

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What tests are available?

The diagnosis is usually made or confirmed by characteristics histopathological features on the skin biopsy. Typical tubers are caseating epithelioid granulomas containing acid-fast bacilli. These are detected by tissue staining, culture and Polymerase chain reaction (PCR)

Other tests that may be necessary include:

  • Tuberculin skin test (Mantoux test or PPD)
  • Gamma interferon release assay blood test
  • Sputum culture (may take a month or more for results to be reported)
  • Chest X-ray and others radiological extrapulmonary infection tests.
  • Interferon Gamma Release Assays (IGRA)
Severe Mantoux test reactions (active TB)

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Mantoux test reaction

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Mantoux test reaction

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Mantoux test reaction

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Mantoux test reaction

What is the treatment for skin tuberculosis?

Patients with pulmonary or extrapulmonary tuberculosis should be treated with antituberculous drugs. This usually involves a combination of antibiotics (isoniazid, rifampin, pyrazinamide, and ethambutol) given over a period of several months, and sometimes years.

Patients with latent TB infection but without active disease can also be treated with anti-TB drugs to prevent the development of active disease. See tuberculosis test.

Occasionally surgical excision of located Cutaneous TB is recommended.