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Skin tuberculosis in children: learning from India

Gomathy Sethuraman1, V Ramesh, M Ramam

  • 1Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi 110029, India. kgsethu@yahoo.com

Dermatologic Clinics
|March 19, 2008
PubMed

Insights

Cutaneous tuberculosis (skin TB) is a significant health issue in Indian children, with changing patterns showing an increase in lichen scrofulosorum. Children may experience more severe and widespread skin TB, often with systemic involvement.

Area of Science:

  • Dermatology
  • Pediatrics
  • Infectious Diseases

Background:

  • Cutaneous tuberculosis (CTB) is a prevalent health concern in India, comprising approximately 1.5% of all extrapulmonary tuberculosis cases.
  • Scrofuloderma and lupus vulgaris are historically the most common clinical presentations of CTB in children.
  • Recent observations indicate a shift in CTB epidemiology, with an increasing incidence of tuberculid forms, particularly lichen scrofulosorum.

Purpose of the Study:

  • To analyze the evolving epidemiological and clinical patterns of cutaneous tuberculosis in pediatric populations in India.
  • To compare the clinical manifestations of CTB in children with those observed in adults.
  • To highlight the unique aspects of CTB presentation in children, including potential for severe disease and systemic involvement.

Main Methods:

  • Retrospective analysis of pediatric CTB cases.
  • Review of clinical presentations, diagnostic methods, and treatment outcomes.
  • Comparison of CTB patterns in children versus adults.

Main Results:

  • Lichen scrofulosorum, a tuberculid, is increasingly observed in pediatric CTB cases.
  • While many clinical patterns resemble adult CTB, children can present with more extensive and severe skin involvement.
  • Uncommon and unusual CTB presentations are more frequently noted in pediatric patients.
  • Systemic involvement is a more common comorbidity in children with CTB compared to adults.

Conclusions:

  • The epidemiology of cutaneous tuberculosis in Indian children is dynamic, with a notable rise in tuberculid presentations like lichen scrofulosorum.
  • Pediatric CTB requires vigilant diagnosis and management due to the potential for severe, widespread disease and associated systemic complications.
  • Understanding these evolving patterns is crucial for timely and effective pediatric dermatological and infectious disease care in endemic regions.

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