Manjunatha, P (2013) Clinical and Histopathological study of Cutaneous Tuberculosis. Masters thesis, Madurai Medical College, Madurai.
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Abstract
Incidence of cutaneous tuberculosis was 0.33 per 1000. The most common type was Lupus vulgaris (21cases, 60%) followed by other types viz. Tuberculosis verrucosa cutis (8 cases, 23%), Scrofuloderma 4 cases 11% and Papulonecrotic tuberculid (2 cases, 6%). Male to female ratio was 1 : 1.2 Age group most commonly affected was in first 3 decades. Lupus vulgaris more commonly seen in females while Tuberculosis verrucosa cutis in males. Most common site of affection was Upper extremity for Lupus vulgaris and Lower extremities for Tuberculosis verrucosa cutis and Neck for Scrofuloderma and Upper and Lower extremities for Papulonecrotic tuberculid. An interesting case of Lupus vulgaris simulating as elastosis perforans serpiginosa over the breast and in one case caused tear of earlobe were observed. No personal past or family history of cutaneous tuberculosis in any patient. Family history of tuberculosis and antitubercular treatment was seen in 2 cases. There was no Co-association of pulmonary tuberculosis with cutaneous tuberculosis in our study. No systemic disease association was found with cutaneous tuberculosis. ESR was raised in all the 35cases. Bacilli positive in two cases of scrofuloderma. Histopathology compatibility was seen according to the clinical morphology. Therapeutic response was observed within 4 weeks. CONCLUSION: Cutaneous tuberculosis constitutes 1 % of all cases of tuberculosis. Clinical morphological types are closely in accordance with the host immunity. With the Lupus vulgaris is being considered by some as the most common type while Scrofuloderma by some authors in various studies with the rising incidence of HIV/AIDS. Tuberculosis verrucosa cutis was previously found to be the most common type now being seen less often and Tuberculids are being reported intermittently by some authors. Diagnosis was based mainly on demonstration of tubercle bacilli in the lesions and by detection of mycobacterium tuberculosis DNA by PCR which is now being used more commonly in the recent times. In our study , bacilli were demonstrable in 2 cases of scrofuloderma by visualisation of smears made from the discharge under fluorescent microscopy. Caseation and bacilli could not be seen in the histological sections studied and diagnosis was mainly based on the clinical morphology of the lesion and histological features with all the cases showing poor to well-formed granulomas along with varying numbers of Langhans’ type giant cells with lymphohistiocytic infiltrate and neutrophils in some cases. After clinical and histological confirmation, we found that Lupus vulgaris was the most common type followed by other types. To conclude a constellation of clinical and histological features were proved vital in the diagnosis of cutaneous tuberculosis in cases where bacilli could not be made out in the sections and where the facility for PCR is not available.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | cutaneous tuberculosis ; Clinical and histopathological study. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Punitha K |
| Date Deposited: | 21 Jun 2018 14:23 |
| Last Modified: | 26 Mar 2020 14:17 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8558 |
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