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Overview of Cutaneous Tuberculosis

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Overview of Cutaneous Tuberculosis Crimson Journal of Skincare CRIMSON PUBLISHERS C Wings to the Research & Hair Therapy Editorial Overview of Cutaneous Tuberculosis Moudad Alamatori* Department of Aesthetic Dermatologist and Venereologist, Damascus University, Syria *Corresponding author: Moudad Alamatori, Department of Aesthetic Dermatologist and Venereologist, Damascus University, Syria Submission: October 10, 2018; Published: October 24, 2018 Introduction Every year on 24th march, world TB day aims to raise Endogenous infections: Occur through the lymphatic system awareness about the disease. Interest in tuberculosis has recently or through the blood been revived, especially in association with the onset of acquired A. Tuberculid: mean 1. Hypersensitivity reactions to Mycobacterium tuberculosis immunodeficiencywe have 8 million syndrome new cases (AIDS) of TB and 3 million deaths per year what is a Cutaneous tuberculosis is an invasion of the skin by 2. Mycobacteria cannot be cultured from the skin lesions Mycobacterium tuberculosis, the same bacteria that cause TB of the B. Tuberculid: lungs. The clinical manifestations are variable and depend on the interaction of several factors including the site of infection and the 1. Lichen scrofulosorum host’s immunity 2. History C. ErythemaScrofuloderma induratum of Bazin TB is an ancient disease Signs of skeletal TB were evident in 1. Lupus vulgaris ancient Egypt (1000 BCE) and was recognized as a contagious discovered Mycobacterium tuberculosis in 1882. disease by the time of Hippocrates (400 BCE) Robert Koch 2.3. OrificialAcute miliary tuberculosis tuberculosis Epidemiology 4. Tuberculous gumma Cutaneous tuberculosis occurs rarely despite a high and Exogenous infections: increasing prevalence of tuberculosis worldwide cutaneous tuberculosis manifestations forms 1.5% Of Extra pulmonary 1. Primary tuberculous chancre Tuberculosis Cutaneous TB is found in less than 0.1% of individuals 2. Tuberculosis verrucosa cutis seen in dermatology clinics. A. Primary tuberculosis chancre: This is a rare form of Infectious Agent cutaneous TB found in areas where there is no vaccination Children Mycobacterium bovis rare, Mycobacterium tuberculosis, Mycobacterium tu- are most likely to suffer from this infection who are not immunized berculosis worker who has acquired TB through accidental inoculation Calmette-Guerin bacillus-BCG (occasionally). with the (BCG). It is commonly seen in health care or laboratory bone marrow stem cells, escaping the immune system and exten- of contaminated material. These infections may occur due to: is an Aerobic bacillus can hide in low oxygen zones with sive, toxic treatment. slow growing nodules or papules. ulcers may develop with painless circumcision, tattooing, ear piercing. The lesions are firm, painless, Patient risk factors regional lymphadenopat [1-12]. Cutaneous TB can occur in people of all ages those with low B. Tuberculosis verrucosa cutis: Occurs after direct immunity due to other infections such as HIV Alcoholism smoking. inoculation of Mycobacterium into the skin in someone who has been Poverty malnutrition and overcrowded living conditions promote previously infected with mycobacteria. The butchers for example spread of the disease. present as a purplish or brownish-red warty growth. Lesions most Classification often occur on the knees, elbows, hands, feet, buttocks, lesions may Exogenous infections: Occur due to an accidental exposure to the infection through a cut Crack wound on the skin. persist for years but can clear up even without treatment (Figure 1). Volume 1 - Issue - 1 Copyright © All rights are reserved by Moudad Alamatori. 1/4 Crimson J Skincare Hair Ther Copyright © Moudad Alamatori Figure 1 C. Tuberculid erythema induratum of bazin: It is a type reddish-brown nodules which slowly enlarge to form irregularly of nodular vasculitis with high degree of immunity to TB because shaped red plaque lesions persist for years. Diascopy test: When pressed with a glass slide the characteristic back of the legs mostly women that may ulcerate and scar heal with of previous infection present as Recurring nodules or lumps on the lesion is a reddish-brown plaque, composed of nodules which show scarring after about nearly 6 week. an ‘apple-jelly’ color. D. Tuberculid lichen scrofulosorum: An eruption of small Pathology follicular papules in young persons with TB. The typical TB lesion is E. Scrofuloderma: Skin lesions result from direct extension into the skin from underlying structures such as lymph nodes, epithelioid granuloma with central caseation necrosis. bone, joints. Often associated with TB of the lungs. The lesions are ulcers occur may heal even without treatment but this takes years 1=zone2=epithelioid of caseating cells, necrosis, firm, painless, subcutaneous swellings cold abscesses and multiple and leaves scars. Is a rare manifestation of cutaneous Orificial tuberculosis: 3=Langhans4=Lymphoid (giant)cells cells, tuberculosis that is caused by auto-inoculation of mycobacteria in patients with advanced internal tuberculosis. That occurs at the mucocutaneous borders of the nose, mouth, anus, urinary meatus, Differentiala rim of fibrosis diagnosis in healing lesions and vagina, and on the mucous membrane of the mouth or tongue. A. Lymphocytoma cutis Acute miliary tuberculosis: Spread from the primary infection B. C. Lupus erythematosus (usually in the lungs) to other organs and tissues via the bloodstream Spitz naevus and abscesses. More likely in immuno compromised patients, e.g. Skin lesions are small red spots millet-sized that develop into ulcers D. Leishmaniasis diagnosed and treated. E. HIV, AIDS, cancer. Prognosis is poor (many patients die) even if Tuberculosis gumma: RosaceaPort-wine stain (syn. metastatic Tuberculosis abscess; G. Leprosy are the most commonly affected sites Lesions can be solitary or F. cold abscess). Arise from haematogenous spread. The extremities multiple, presenting as a subcutaneous nodule or tender abscess. H. Sarcoidosis Lupus vulgaris: The most common form of skin tuberculosis I. Psoriasis 50,000 new cases occurs throughout the world every year J. Bowen’s disease progressive form of tuberculosis of the skin occurring in individuals Lichen simplex chronicus (Fitzpatrick’s). Lupus vulgaris is an extremely chronic and with moderate immunity and a high degree of tuberculin sensitivity. L. Wegener’s granulomatosis The pathogen may reach the skin Via the blood or lymph from a K. tuberculous internal organ lung from underlying infected glands or M. Blastomycosis. joints may also develop at site of BCG vaccination. Most cases affect N. Deep fungal infection the head and neck, especially around the nose It begins as painless O. tertiary syphilis Volume 1 - Issue - 1 How to cite this article: Moudad Alamatori. Overview of Cutaneous Tuberculosis. Crimson J Skincare Hair Ther .1(1). CJSH.000502. 2018. 2/4 Crimson J Skincare Hair Ther Copyright © Moudad Alamatori P. Basal cell carcinoma Table 2. Diagnosis Therapy The individual Medical history. On diascopy, it shows 600mg/day characteristic “apple-jelly “color Biopsy will reveal tuberculoid Rifampicin 300mg/day 24]. EthambutolIsoniazid 1200mg/day granuloma with few bacilli (very rare). Mantoux test is positive [12- Case Report 1500mg/day I accompanied this patient 20 years ago from1997 tell 2018 Pyrazinamide therapy for 2 months 600mg/day 20-year-old female. As-Suwayda Syria with a 3-year-history of painless, soft nodules, slowly growing, red-brown and irregularly Rifampicin 300mg/day shaped plaques on her face. ReferencesIsoniazid therapy for 10 months A well demarcated, slightly elevated sharply edges ulcers. 1. Bravo FG, Gotuzzo E (2007) Cutaneous tuberculosis. Clin Dermatol 2. Infiltrated erythema papules. Erythrematous scaly plaque. Atrophic 25(2): 173-180. columella and the cartilage of the nasal septum nearly Total clinical, histopathologic, and bacteriologic study. J Am Acad Dermatol scars fibrosis destruction of nasal tissue and Nasal septum and tissues loss of the examination of the oral cavity. Oral mucosae Fariña MC, Gegundez MI, Piqué E (1995) Cutaneous tuberculosis: A were involved. Small ulcers pink papules bleed easily enlargement 3. 33(3): 433-440. region lymph nodes. Multiple bilateral submandibular lymph nodes 245-255. MacGregor RR (1995) Cutaneous tuberculosis. Clin Dermatol 13(3): were palpabl. In the previous medical patient’s history nearly two 4. observations of cutaneous tuberculosis in Larkana, Pakistan. Int J Bhutto AM, Solangi A, Khaskhely NM (2002) Clinical and epidemiological treated with glucantime. Intra muscular and topical injection for year ago leishmaniasis ?? first diagnosis was. The patient had been nearly one year no improvement has been occurred thinking about 5. Dermatol 41(3): 159-165. lupus vulgaris. Barbagallo J, Tager P, Ingleton R (2002) Cutaneous tuberculosis: 6. Diagnosis and treatment. Am J Clin Dermatol 3(5): 319-328. Investigation (Table 1) Handog EB, Gabriel TG, Pineda RT (2008) Management of cutaneous Table 1. 7. tuberculosis. Dermatol Ther 21(3): 154-161. coexisting with scrofuloderma and tubercular lymphadenitis. Dermatol Leishmaniasis test for many times negative Rai VM, Shenoi SD, Gowrinath (2005) Tuberculous gluteal abscess Tuberculin test positive 8. Online J 11(3): 14. Bacilli existence in sputum and Nasal secretions for negative Lai-Chong JE, Perez A, Tang V (2007) Cutaneous manifestations of many times 9. tuberculosis. Clin Exp Dermatol 32(4): 461-466. X-ray head and chest normal Brown FS, Anderson RH, Burnett JW (1982) Cutaneous tuberculosis.
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