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Cutaneous tuberculosis on the scalp: a case report.

Bruno Hassunuma Carneiro1, André Gama Palone1, Carine Andrade Celeira Zanlorenzi1

  • 1Department of Internal Medicine, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil.

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Summary

Tuberculosis (TB) can present atypically, affecting systems beyond the lungs. This case highlights a rare scalp ulcer caused by Mycobacterium tuberculosis, successfully treated with standard anti-TB drugs.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Oncology

Background:

  • Tuberculosis (TB) typically affects the lungs but can manifest with extrapulmonary symptoms.
  • Extrapulmonary TB can present with diverse and unusual clinical findings.
  • Co-existing malignancies may complicate the diagnosis and management of infectious diseases.

Observation:

  • A 76-year-old male presented with a painful, enlarging scalp ulcer and cough.
  • Physical examination revealed a 10 cm tender scalp ulcer with yellow crusts.
  • Biopsy showed inflammation and neutrophilic infiltrates; acid-fast bacilli were detected.

Findings:

  • Microscopic examination and molecular testing confirmed Mycobacterium tuberculosis DNA.
  • Culture identified pan-sensitive M. tuberculosis.
  • CT scans revealed a frontoparietal osteolytic lesion and pulmonary consolidation.

Implications:

  • This case underscores the importance of considering tuberculosis in patients with atypical skin lesions, even in the absence of classic pulmonary symptoms.
  • Early diagnosis and appropriate combination therapy are crucial for managing disseminated tuberculosis.
  • The successful treatment of this rare presentation emphasizes the efficacy of standard anti-TB regimens.