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Cutaneous tuberculosis: a clinical, histopathologic, and bacteriologic study

M C Fariña1, M I Gegundez, E Piqué

  • 1Department of Dermatology, Fundación Jímenez Díaz, Clínica Nuestra Señora de la Concepción, Universidad Autónoma, Madrid, Spain.

Journal of the American Academy of Dermatology
|September 1, 1995
PubMed
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Cutaneous tuberculosis (TB) infections are increasing in immunocompromised patients, often presenting with atypical lesions. Early diagnosis via M. tuberculosis cultures is crucial, even if initial stains are negative.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Microbiology

Background:

  • Cutaneous infections caused by Mycobacterium tuberculosis (TB) are increasingly observed, particularly in immunocompromised individuals.
  • These infections may present with atypical clinical manifestations, posing diagnostic challenges.

Purpose of the Study:

  • To analyze the clinical, histopathologic, and bacteriologic data of 11 patients with various forms of cutaneous tuberculosis.
  • To highlight the importance of microbiological confirmation in suspected cases.

Main Methods:

  • Inclusion criteria: isolation of M. tuberculosis from skin biopsy, sinus drainage, or cutaneous abscess aspirates.
  • Histopathologic examination of skin biopsy specimens was performed in most patients.
  • Combined antituberculous therapy was administered to the majority of patients.

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Main Results:

  • Diagnoses included scrofuloderma, cutaneous miliary tuberculosis, lupus vulgaris, and tuberculous gumma.
  • Most patients (8/11) had evidence of concurrent or prior tuberculous foci outside the skin.
  • Histopathologic findings were diverse and dependent on the specific type of cutaneous tuberculosis.

Conclusions:

  • Atypical cutaneous tuberculosis lesions can occur in immunocompromised patients.
  • M. tuberculosis cultures are essential for diagnosing suspected cutaneous TB, even with negative acid-fast bacilli stains.