Hypochromia as a clinical sign of tuberculosis in the tropics

The skin colour of 106 Nigerian tuberculosis patients was measured by colorimetry; and a relative hypochromia, particularly of the face, was found to be associated with tuberculous infection. The hypochromia reached a significant degree compared to a group of 126 control patients with other medical conditions from whom tuberculosis had been excluded. Successful treatment of the tuberculosis resulted in re-pigmentation. It is suggested that relative hypochromia should be included in the list of non-specific signs which may be looked for when considering tuberculosis in the differential diagnosis of chronic cough, and debilitating disease, in the African. The hypochromia of protein-calorie malnutrition was not included in the study, but its importance in relation to coincident tuberculosis is noted. A simple method of measuring skin colour in the consulting room needs to be developed.