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Tuberculous gumma following venepuncture.
1Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni M Claret 167, 08025 Barcelona, Spain.
The British Journal of Dermatology
|March 22, 2001
Summary
Tuberculosis can manifest in the skin, even years after initial infection. A rare skin form, tuberculous gumma, can develop after minor trauma like a blood draw and resolves with standard treatment.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Tuberculosis (TB) typically affects the lungs but can manifest in extrapulmonary sites.
- Cutaneous TB is rare, often presenting as chronic, non-healing lesions.
- Previous injury is a potential trigger for localized TB reactivation.
Observation:
- An 88-year-old male presented with a 2-year history of a growing, ulcerated nodule on his left wrist.
- The lesion appeared after a venous blood test, suggesting a potential inoculation site.
- Skin biopsy revealed granulomas, but initial stains were negative.
Findings:
- Cultures from the skin biopsy confirmed the presence of Mycobacterium tuberculosis.
- Bone and joint involvement were ruled out through imaging.
- The patient achieved complete healing after 6 months of standard antituberculous therapy.
Implications:
- This case highlights Mycobacterium tuberculosis as a cause of cutaneous gumma.
- Minor trauma can lead to localized reactivation of tuberculosis in susceptible individuals.
- Standard antituberculous treatment is effective for managing cutaneous tuberculous gumma.