Unusual Sites of Cutaneous Tuberculosis: A Report of Two Cases.

Dimple Chopra,Siddharth Chopra,Deepak Goyal,Aastha Sharma,Shivali Aggarwal,Vishal Chopra

doi:10.1155/2017/7285169

Dimple Chopra, Siddharth Chopra + Show 4 more

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https://doi.org/10.1155/2017/7285169

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Abstract

Cutaneous tuberculosis (CTB) is an uncommon small subset of extrapulmonary tuberculosis, comprising 1–1.5% of all extrapulmonary tuberculosis manifestations, which manifests only in 8.4–13.7% of all tuberculosis cases. Lupus vulgaris (LV) and tuberculosis verrucosa cutis (TBVC) are forms of reinfection tuberculosis and often occur in presensitized patients, by exogenous inoculation. We report two cases of cutaneous tuberculosis at unusual sites. A 35-year-old female having a forehead lesion for 2 years was diagnosed as having tuberculosis verrucosa cutis and another 16-year-old girl with lesion in left axilla for 10 years was proven to have lupus vulgaris. The delayed diagnosis was possibly due to lower clinical suspicion due to the presentation of CTB at unusual sites. This highlights the importance of keeping TB as an important differential as misdiagnosis or delayed diagnosis of this entity can lead to prolonged morbidity.

Highlights

We report a case of tuberculosis verrucosa cutis (TBVC) presenting as a warty lesion on the forehead and of lupus vulgaris (LV) in the axilla which is a rare presentation
A diagnosis of tuberculosis verrucosa cutis was made, and the patient was started on category 1 treatment as per Revised National TB Control Programme (RNTCP) with which the lesions improved
Diagnosis of lupus vulgaris was made and she was put on category 1 treatment as per Revised National TB Control Programme (RNTCP) with which the lesions improved

Summary

Introduction

Cutaneous tuberculosis (CTB) comprises a small fraction (2%) of incident cases of TB [1] and the incidence has decreased from 2% to 0.5% [2]. It can present in many different manifestations. The site and clinical picture of CTB can at times be confusing leading to a delay in diagnosis of the disease as happened in these two cases. We report a case of tuberculosis verrucosa cutis (TBVC) presenting as a warty lesion on the forehead and of lupus vulgaris (LV) in the axilla which is a rare presentation

Case Report

Findings

Discussion