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Published on: August 11, 2008
Cutaneous tuberculosis in children from the northeastern region of Morocco
Insights
Cutaneous tuberculosis (CT) in Moroccan children is primarily scrofuloderma and gummas. Early diagnosis and treatment lead to favorable outcomes, even without immunocompromise, highlighting the importance of vigilance despite BCG vaccination.
Area of Science:
- Dermatology
- Pediatrics
- Infectious Diseases
Background:
- Tuberculosis is endemic in Morocco.
- Cutaneous tuberculosis (CT) presents unique challenges in pediatric populations.
- Understanding CT characteristics is crucial for effective management.
Purpose of the Study:
- To investigate the epidemiological, paraclinical, therapeutic, and progressive features of CT in children.
- To analyze clinical presentations and diagnostic methods for pediatric CT.
- To evaluate treatment outcomes and identify risk factors for sequelae.
Main Methods:
- A multicenter retrospective and prospective study.
- Involved pediatric patients diagnosed with CT.
- Diagnosis based on clinical, immunological, bacteriological, and histological data.
Main Results:
- 16 pediatric CT cases identified out of 147 total CT cases.
- Scrofuloderma (57%) and gummas (35%) were the most common clinical forms.
- All cases showed favorable progression with treatment, though some had sequelae.
Conclusions:
- Pediatric CT in Morocco is characterized by scrofuloderma and gummas.
- Early diagnosis and appropriate antibacillary treatment are vital for favorable outcomes.
- Despite BCG vaccination, vigilance for CT in children remains essential.
Introduction:
In Morocco, tuberculosis is an endemic disease. The aim of this study was to trace the epidemiological, paraclinical, therapeutic, and progressive characteristics of cutaneous tuberculosis (CT) in children.
Materials And Method:
This multicenter retrospective and prospective study concerned all pediatric patients followed for CT in our region. The diagnosis was based on comparing clinical, immunological, bacteriological, and histological data.
Results:
We found 147 cases of CT, of which 16 cases (10%) were children. The average age was 10.5 years, with extremes ranging from 15 months to 16 years. The sex ratio was 0.75. Deterioration in general condition and weight loss were noted in three cases, and none of the patients was immunocompromised. The clinical forms were essentially scrofuloderma tuberculosis in nine cases (57%), gummas in five cases (35%), a single case each of verrucous tuberculosis and lupus vulgaris. The histological study of the lesions confirmed the diagnosis for all cases by showing a tuberculous granuloma. Multifocal forms were found in one case. Antibacillary treatment was recommended for 6 months in all patients except in the child with a multifocal form whose treatment was prolonged to 9 months. The progression was favorable with total healing in all cases except in a single case that retained sequelae such as bone deformities and scars in most cases.
Discussion:
Cutaneous tuberculosis in children is dominated by scrofuloderma and gummy lesions in our region. Despite deterioration in the general condition and weight loss in three cases, none of these children was immunocompromised. Therapeutic management was then carried out based on several clinical and paraclinical arguments and the histological study. Even if the compulsory BCG vaccine in Morocco prevents serious forms, early diagnosis remains the only way to reduce the risk of complications.
Conclusion:
Cutaneous tuberculosis concerns our pediatric population, multibacillary forms of cutaneous localization is the most frequent one, although the BCG vaccine in Morocco is compulsory.
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