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Superficial thrombophlebitic tuberculide
Hendrick M Motswaledi1, E Joy Schulz
1Department of Dermatology, University of Limpopo, South Africa. griet@webmail.co.za
International Journal of Dermatology
|November 2, 2006
Summary
This study identifies a fourth type of tuberculide, a rare skin reaction to tuberculosis, presenting as superficial thrombophlebitis. Early diagnosis and treatment with antituberculous therapy are crucial for managing this condition.
Area of Science:
- Dermatology
- Infectious Diseases
- Immunology
Background:
- Tuberculides are cutaneous manifestations of disseminated Mycobacterium tuberculosis infection.
- Existing classifications include papulonecrotic tuberculide, erythema induratum of Bazin, and lichen scrofulosorum.
- A potential fourth type, "nodular granulomatous phlebitis," was previously described.
Observation:
- A South African man presented with superficial vein thickening and nodular lesions on his lower legs.
- The patient exhibited a positive tuberculin reaction but no systemic tuberculosis.
- Histopathology revealed granulomatous inflammation localized to superficial veins.
Findings:
- Polymerase chain reaction (PCR) confirmed Mycobacterium tuberculosis DNA in the affected veins.
- Acid-fast bacilli stains and cultures were negative.
- Lesions showed rapid improvement with antituberculous treatment.
Implications:
- The findings support the recognition of a distinct fourth tuberculide.
- The proposed term "superficial thrombophlebitic tuberculide" better reflects the clinical presentation.
- This condition requires consideration in the differential diagnosis of superficial thrombophlebitis.
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