Abstract
Cutaneous tuberculosis is a rare, extra-pulmonary form of tuberculosis caused by mycobacteria of the tuberculosis complex. It is characterized by clinical polymorphism often posing a difficult diagnostic challenge. Herein, we report a case of cutaneous tuberculosis in its warty form located on the nose. This was a 57-year-old patient who was infected in the classroom three months previously while taking lessons from a woman with pulmonary tuberculosis. A facial examination revealed a blackish, papillomatous patch invading almost the entire nose, with a keratotic surface spreading over the wings of the nose. The diagnosis of verrucous tuberculosis was reached on the basis of epidemiological, clinical, and paraclinical arguments. Under anti-tuberculosis treatment for six months, the lesion had healed without sequelae. The diagnosis of verrucous cutaneous tuberculosis must be established in the presence of any chronic and crusty lesion. The management responds to the treatment protocol for all forms of tuberculosis.
Highlights
Cutaneous tuberculosis includes all cutaneous manifestations due to mycobacteria of the tuberculosis complex: Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium africanum [1]
We report a case of cutaneous tuberculosis in its warty form located on the nose
Warty cutaneous tuberculosis results from skin re-inoculation of Koch’s bacillus in a previously sensitized subject [5,7,8,9], yet this notion of reinoculation was not reported in our patient
Summary
Cutaneous tuberculosis includes all cutaneous manifestations due to mycobacteria of the tuberculosis complex: Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium africanum [1]. We report a case of cutaneous tuberculosis in its warty form located on the nose. This was a 57-year-old housewife who consulted on March 10, 2018, for a keratotic lesion located on the nose and evolving for three months. A dermatological examination revealed a blackish, keratotic patch with a crusty, melliceric surface covering the entire nasal mass with an overflow in the nasolabial folds (Fig. 1). This lesion was neither itchy nor painful. Significant lysis of the keratosis was noted at month three of treatment (Fig. 3), and clinical healing without sequelae was noted at month six of treatment with a two-year follow-up (Fig. 4)
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