Tuberculosis Verrucosa Cutis on the Buttocks: A Case Report

Abstract

Introduction: Tuberculosis verrucosa cutis is a rare form of cutaneous tuberculosis and occurs commonly on the lower extremeties (hand, thighs and buttock). It is often missed as other cutaneous verrucosa dieases and the pathogens of cutaneous tuberculosis is difficult to find. We showed an unusual case of tuberculosis verrucosa cutis on both buttocks. Case presentation: A 54 Chinese male presented with 9-year history of asymptomatic verrucous lesions on bilateral buttocks. Lesions presented a well-defined plaque, verrucous lesion and yellow pus discharge on buttocks. The skin biopsy showed pseudoepitheliomatous hyperplasia of the epidermis and dermal granulomatous inflammation composed of epithelioid histiocytes and mixed inflammatory cells. The tuberculin test and the polymerase chain reaction for Mycobacterium tuberculosis were negative, but T-spot test were positive. the treatment of antituberculosis showed favourable effect. Finally, the diagnosis of tuberculosis verrucosa cuti was made. Discussion: Tuberculosis verrucosa cutis is easily confused with other verrucous diseases, such as verrucous porokeratosis, discoid lupus erythematosus hypertrophicus lichen planus, chromoblastomycosis. Diagnostic therapy is usually recommended for most of these diagnoses. Conclusion: A diagnosis of tuberculosis verrucosa cutis should be taken correctly based on the combination of clinical manifestions, histopathological characteristics, laboratory findings and diagnostic therapy. It is vital for dermatologists to be aware of verrucous lesions since a delay in diagnosis can lead to aggravate the disease, abuse of glucocorticoids.