A very rare case of scrofuloderma with multiple cervical lymphadenitis tuberculosis

Scrofuloderma is a clinical form of secondary cutaneous tuberculosis. It is commonly characterized by bluish-red nodules that cover the lymph nodes, bones or joints, disrupting the affected tissue to be replaced with granulation tissue. We reported a case of 10-year-old boy with ulcers in the cervical and axillary region. The lesion began as papules, which gradually developed into nodules and pustules. Chronic cough was also found, however chest x ray was normal and sputum direct smear for acid fast bacil was negative. Histopathologic finding of tissue biopsy revealed epidermal necrosis in the central part surrounded by granulomatous tissue forming an abscess and histiocyte infiltrates, confirming the diagnosis of scrofuloderma. CT Scan of neck showed multiple enlarged lymph nodes, and FNAB result was suggestive for tuberculous lymphadenitis. Patient was then given anti-tuberculosis therapy. Four months later, the ulcers began to resolve and heal gradually.