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Changing pattern of cutaneous tuberculosis. A prospective study.
V N Sehgal1, M K Jain, G Srivastava
1Department of Dermatology and Venereology, Maulana Azad Medical College, New Delhi, India.
International Journal of Dermatology
|May 1, 1989
Summary
Cutaneous tuberculosis incidence is rising, primarily affecting adult men. Diagnosis relies on clinical signs, histopathology, and Mycobacterium tuberculosis detection, with treatment response aiding confirmation.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Cutaneous tuberculosis (CTB) incidence shows an upward trend over the past three years.
- CTB predominantly affects adult men, with distinct patterns for reinfection (lupus vulgaris, tuberculosis verrucosa cutis) and reactivation (scrofuloderma) forms.
Purpose of the Study:
- To analyze the changing patterns of cutaneous tuberculosis.
- To evaluate diagnostic parameters for CTB, including clinical presentation, histopathology, and microbiological confirmation.
Main Methods:
- Retrospective analysis of CTB cases over three years.
- Clinical assessment, histopathological examination, and microbiological tests (smears, in vitro culture) for Mycobacterium tuberculosis.
- Evaluation of diagnostic criteria including clinical history, disease evolution, and response to antitubercular drugs.
Main Results:
- CTB incidence increased, predominantly in adult males.
- Reinfection forms (lupus vulgaris, TVC) affected adults, while reactivation (scrofuloderma) was more common in children.
- Clinical manifestations largely aligned with classical descriptions, though apple-jelly nodules were infrequent. Extremity involvement in lupus vulgaris was notable.
- Histopathology confirmed clinical diagnoses; definitive confirmation relied on Mycobacterium tuberculosis detection.
Conclusions:
- Diagnosis of CTB can be reasonably made using a combination of clinical features, disease history, histopathology, and response to treatment, especially given limitations in direct microbiological confirmation.
- Understanding evolving CTB patterns is crucial for timely diagnosis and management.