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Disseminated tuberculosis presenting as medium-vessel vasculitis in an immunocompromised host
Jennifer Y Wang1,2, Ryanne A Brown1,2, Silvina Pugliese1
1Department of Dermatology, Stanford University Medical Center, Stanford, California, USA.
Journal of Cutaneous Pathology
|March 6, 2020
Summary
Disseminated tuberculosis can present unusually in the skin, mimicking other conditions. Early diagnosis and treatment are crucial for managing this rare presentation of cutaneous tuberculosis.
Area of Science:
- Dermatology
- Infectious Diseases
- Pathology
Background:
- Cutaneous tuberculosis (TB) is rare, with varied clinical and histopathological presentations.
- Immunosuppression can predispose individuals to disseminated infections, including TB.
Observation:
- A 55-year-old male on immunosuppressants for dermatomyositis developed soft tissue abscesses and a skin plaque.
- Skin biopsy revealed necrotizing medium-vessel vasculitis.
Findings:
- Mycobacterium tuberculosis was identified in the skin lesion via acid-fast bacilli stain, culture, and PCR.
- The patient's cutaneous findings resolved rapidly with antituberculosis therapy.
Implications:
- This case highlights an atypical presentation of cutaneous tuberculosis mimicking vasculitis in an immunosuppressed patient.
- Highlights the importance of considering disseminated TB in patients with unusual skin manifestations under immunosuppression.
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