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Tuberculosis verrucosa cutis associated with tuberculous lymphadenitis
M B Pereira1, M K Gomes, F Pereira
1Division of Dermatology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
International Journal of Dermatology
|December 21, 2000
Summary
A rare case of cutaneous tuberculosis in an immunocompetent adult is presented. Diagnosis was confirmed by Mycobacterium culture, and multidrug therapy led to an excellent treatment response.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Cutaneous tuberculosis is a rare manifestation of Mycobacterium infection, often presenting a diagnostic challenge.
- This case highlights a chronic, slowly progressing lesion in an immunocompetent adult with a history of bacillus Calmette-Guérin (BCG) vaccination.
Observation:
- A 34-year-old man presented with a large, 21-year-old, indurated plaque on his left thigh and buttock.
- Initial investigations including HIV testing and fungal stains were negative. Purified protein derivative (PPD) test showed significant induration.
Findings:
- Histopathology revealed epidermal changes and dermal inflammation. Lymph node biopsy showed granulomas with necrosis.
- Tissue cultures were positive for Mycobacterium, confirming tuberculosis. Ziehl-Neelsen staining was negative.
- The patient responded well to a 6-month multidrug regimen of rifampin, isoniazid, and pyrazinamide.
Implications:
- This case underscores the importance of considering cutaneous tuberculosis in the differential diagnosis of chronic skin lesions, even in immunocompetent individuals.
- Early diagnosis and appropriate multidrug therapy are crucial for successful management and preventing complications.