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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
Published on: September 20, 2018
Scrofuloderma--a case series from rural India
Sumit Kar1, Ajay Krishnan, Nitin Gangane
1Department of Dermatology, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram, Wardha, Maharashtra. karmgims@gmail.com
Insights
Cutaneous tuberculosis, a rare form of tuberculosis, often presents as scrofuloderma in India, particularly affecting malnourished children and young adults. Diagnosis requires Mantoux testing, cytology, and histopathology, with treatment focusing on medical therapy and addressing immunosuppression.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Cutaneous tuberculosis (TB) is an uncommon manifestation of Mycobacterium tuberculosis infection.
- Scrofuloderma is a prevalent form of cutaneous TB in India, predominantly affecting children and young adults.
- Risk factors include malnutrition and immunosuppression, necessitating comprehensive diagnostic approaches.
Observation:
- A series of malnourished children presenting with diverse clinical features of scrofuloderma in rural central India were studied.
- Diagnosis was confirmed through Mantoux test, fine needle aspiration cytology (FNAC), and histopathological examination.
- Clinical presentation varied widely, underscoring the need for a multi-pronged diagnostic strategy.
Findings:
- Scrofuloderma predominantly affects males (1.5:1 ratio) within the first three decades of life.
- Malnourished children in a tertiary care setting exhibited a broad spectrum of clinical manifestations.
- Diagnostic confirmation relied on a combination of clinical, cytological, and histological findings.
Implications:
- Early diagnosis and treatment of scrofuloderma are crucial for preventing complications.
- Identifying and managing underlying immunosuppressive conditions is essential for effective TB management.
- Public health initiatives targeting malnutrition and TB awareness in rural India are vital.
Abstract:
Cutaneous tuberculosis is the rarest presentation of all the forms of tuberculosis. Scrofuloderma is a frequent manifestation of cutaneous tuberculosis in Indian scenario. Males are affected one and half times more than females. The most common affected age group showing clinical infection is within the first three decades of life. A series of cases mostly malnourished children attending a tertiary care centre in a rural area of central India is being reported. They have presented with a wide spectrum of clinical features, forcing us to establish the final diagnosis by Mantoux test, fine needle aspiration cytology and histopathological examination. The mainstay of treatment remains medical therapy but the underlying cause for severe immunosuppression needs to be ruled out and treated.
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