Clinical profile of cutaneous tuberculosis at Nashik

Abstract

This study was conducted to determine the clinical pattern, nature and prevalence of cutaneous tuberculosis in Nashik, India. We report 52 cases of cutaneous tuberculosis that were diagnosed at our outpatient department from January 2018 to December 2019. All the cases were diagnosed clinically, and biopsies were examined for histopathological evidence. Clinically, 26 (50%) cases of lupus vulgaris, 15 (29%) of scrofuloderma, six (12%) of tuberculosis verrucosa cutis, four (8%) of papulonectrotic tuberculid, and one (2%) of lichen scrofulosorum were observed in our department from 2018 to 2019. All the patients were between 5 and 65 years old. Five patients were children under 10, 29 (56%) were between 10 and 30 years old, 13 (25%) were between 30 and 50 years old, and five (10%) were over 50. There was a male (64%) predominance compared to female patients (37%). Histopathology of all the specimens showed granulomatous changes, in the majority of cases Langhans giant cells. Epithelioid cell infiltration and other inflammatory cells, such as lymphocytes, neutrophils, and eosinophils, were seen in ulcerated lesions. The study had some limitations. The sample size was small and the study was carried out in a rural setting, where agriculture is the main source of income and most of the patients treated are farm laborers. Lupus vulgaris was the most common form of cutaneous tuberculosis in this area. The incidence was higher in working adult males, indicating that trauma may be one of the causes of cutaneous tuberculosis. The high rate of clinical-histological confirmation seen in this study emphasizes the importance of skin biopsy in patients with cutaneous TB.