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Related Experiment Videos

Scrofuloderma: a forgotten disease?

Arzu Kiliç1, Ulker Gül, Seçil Soylu

  • 1Dermatology Clinic Ankara Numune Education and Research Hospital, Ankara, Turkey. kilicarzu2004@yahoo.com

Skinmed
|November 3, 2007
PubMed
Summary
This summary is machine-generated.

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Scrofuloderma, a skin infection caused by Mycobacterium tuberculosis, presented as neck lesions unresponsive to antibiotics. Diagnosis was confirmed by biopsy, and treatment with anti-tuberculosis drugs led to lesion improvement.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Microbiology

Background:

  • Scrofuloderma is a cutaneous manifestation of tuberculosis (TB), typically affecting the head and neck region.
  • It often presents as chronic, non-healing ulcers and sinus tracts, posing diagnostic challenges due to varied clinical presentations.
  • This case highlights the importance of considering TB in endemic areas, even with atypical presentations and negative initial sputum tests.

Observation:

  • A 30-year-old woman presented with a 2-year history of progressive, crusted lesions and swelling in the left submandibular and neck region.
  • Physical examination revealed erythematous nodules, an ulcerated lesion, and a sinus tract, accompanied by cervical lymphadenopathy and mild fever.
  • Initial investigations, including blood tests, sputum analysis, and imaging, were largely unremarkable, with negative results for common infections and TB.

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Findings:

  • Biopsy of the cervical lesions demonstrated granulomatous inflammation with caseation necrosis and positive staining for acid-fast bacilli.
  • Culture of the biopsy specimen confirmed the presence of Mycobacterium tuberculosis, establishing the diagnosis of scrofuloderma.
  • The purified protein derivative (PPD) test showed an 18-mm induration, suggestive of prior exposure to tuberculosis.

Implications:

  • This case underscores the diagnostic value of skin biopsy and culture in suspected scrofuloderma, especially when systemic TB investigations are negative.
  • Prompt initiation of multi-drug anti-tuberculosis therapy is crucial for successful management and resolution of cutaneous lesions.
  • Effective treatment led to significant clinical improvement, emphasizing the curability of scrofuloderma with appropriate antitubercular regimens.