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Chronic osteomyelitis of humerus presenting as scrofuloderma.

Susmita Sahu¹, Satyadarshi Pattnaik, Indrani Mohanty

¹Department of Microbiology, M.K.C.G Medical College, Berhampur, Odisha, India.

Indian Journal of Dermatology

|October 2, 2013

Summary

Scrofuloderma, a form of cutaneous tuberculosis, can affect bones and joints, leading to ulcers and sinuses. This case highlights successful treatment of a rare arm manifestation with antitubercular therapy.

Keywords:

Osteomyelitis scrofuloderma tuberculosis

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Area of Science:

Dermatology
Infectious Diseases
Microbiology

Background:

Scrofuloderma is a cutaneous manifestation of tuberculosis.
It commonly affects lymph nodes, bones, or joints, causing ulcers and draining sinuses.
This case presents a rare presentation of scrofuloderma involving the arm.

Purpose of the Study:

To report a rare case of scrofuloderma affecting the arm.
To illustrate the diagnostic challenges and successful treatment of cutaneous tuberculosis.
To emphasize the importance of considering tuberculosis in endemic areas.

Main Methods:

A clinical case presentation of a 22-year-old woman with nodulo-ulcerative lesions and swelling of the right arm.
Diagnostic workup included routine investigations, X-ray of the humerus, and microbiological analysis of discharge and skin biopsy.
Molecular confirmation using Polymerase Chain Reaction (PCR) and histopathological examination.

Main Results:

X-ray revealed chronic osteomyelitis of the humerus.
Microbiological cultures of discharge were negative for common pathogens.
Skin biopsy culture and PCR confirmed Mycobacterium tuberculosis infection.
Histopathology showed epithelioid granulomatous inflammation consistent with tuberculosis.

Conclusions:

Antitubercular therapy led to complete regression of the skin lesions and arm swelling.
This case underscores the importance of considering scrofuloderma in the differential diagnosis of chronic limb swelling and ulcerative lesions.
Early diagnosis and appropriate treatment are crucial for favorable outcomes in cutaneous tuberculosis.