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A Rare Case of Scrofuloderma Presenting as Recurrent Tuberculosis in a Young Patient
Yoshihiro Okada1, Asuka Okada1,2, Shin Miyagawa1
1Department of Respiratory Medicine Osaka Saiseikai Suita Hospital Suita Osaka Japan.
Respirology Case Reports
|July 28, 2026
Summary
Tuberculosis (TB) can recur and present as scroderma, a skin ulcer, due to the contiguous spread from underlying chest abscesses. Prompt diagnosis of skin ulcers involves histopathological and bacteriological assessments.
Area of Science:
- Infectious Diseases
- Dermatology
- Pulmonology
Background:
- A 23-year-old Indonesian man with a history of pulmonary tuberculosis presented with a chest wall skin ulcer.
- Recurrent tuberculosis can arise from residual strains or reinfection.
Purpose of the Study:
- To report a case of recurrent tuberculosis manifesting as scrofuloderma.
- To highlight the diagnostic approach for unusual presentations of tuberculosis.
Main Methods:
- Clinical examination, chest ultrasonography, and computed tomography were performed.
- Histopathological examination of a skin biopsy and polymerase chain reaction (PCR) for Mycobacterium tuberculosis were conducted on ulcer exudate.
Main Results:
- Imaging revealed intercostal abscesses and pleural thickening with calcification.
- Histology and PCR confirmed Mycobacterium tuberculosis in the skin ulcer and exudate.
- The patient was diagnosed with scrofuloderma and multiple intercostal abscesses secondary to recurrent tuberculosis.
Conclusions:
- Recurrent tuberculosis can present as scrofuloderma via contiguous spread from underlying abscesses.
- Thorough histopathological and bacteriological assessments are crucial for diagnosing skin ulcers of unclear etiology.
- This case underscores the importance of considering tuberculosis in patients with atypical skin manifestations, especially those with a prior history.
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