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Cutaneous tuberculosis in children: the Indian perspective
Archana Singal1, Sidharth Sonthalia
1Department of Dermatology and STD, University College of Medical Sciences & GTB Hospital (University of Delhi), Dilshad Garden, Delhi, India. archanasingal@hotmail.com
Indian Journal of Dermatology, Venereology and Leprology
|September 10, 2010
Summary
Cutaneous tuberculosis (TB) remains a challenge in children, particularly in India. Diagnosis involves histopathology, cultures, and PCR, with treatment following extrapulmonary TB guidelines.
Area of Science:
- Dermatology
- Infectious Diseases
- Pediatrics
Background:
- Cutaneous tuberculosis (TB) is a significant global health issue, accounting for 1.5% of extrapulmonary TB cases.
- Prevalence in Indian children ranges from 18-54%, with peak incidence in the 10-14 age group and frequent intrafamilial transmission.
- While BCG efficacy is debated, scrofuloderma (SFD), lupus vulgaris (LV), and tuberculosis verrucosa cutis (TBVC) are common clinical types.
Purpose of the Study:
- To summarize the epidemiology, clinical presentation, diagnosis, and management of cutaneous tuberculosis in children.
- To highlight diagnostic modalities and treatment strategies for pediatric cutaneous TB.
Main Methods:
- Review of existing literature on childhood cutaneous tuberculosis.
- Analysis of diagnostic approaches including histopathology, microbiological cultures (LJ medium, BACTEC 460 TB), PCR, Mantoux test, and therapeutic trials.
- Emphasis on clinical evaluation for associated systemic TB foci.
Main Results:
- Scrofuloderma (SFD) is the most frequent clinical variant, followed by lupus vulgaris (LV) and tuberculosis verrucosa cutis (TBVC).
- Lichen scrofulosorum (LS) is often linked to systemic TB (72% of cases).
- HIV impact on childhood cutaneous TB appears minimal.
Conclusions:
- Diagnosis relies on a combination of histopathology, cultures, PCR, and clinical assessment.
- Treatment protocols for pediatric cutaneous TB align with those for extrapulmonary tuberculosis.
- Identifying associated systemic TB foci is crucial for guiding treatment duration.
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