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.

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