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Chapter 26 : Cutaneous Tuberculosis

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Cutaneous Tuberculosis, Page 1 of 2

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Abstract:

Cutaneous tuberculosis (TB) is not a well-defined entity but comprises a wide spectrum of clinical manifestations. Primary inoculation TB results from the entry of mycobacteria into the skin or, less frequently, the mucosa of a person who has not previously been infected or who has no natural or artificial immunity to . The pathogenesis of cutaneous TB from an exogenous source is similar to that of other primary diseases. Lupus vulgaris is a particular type of chronic cutaneous TB in a previously sensitized person with a high degree of TB sensitivity. The histopathological picture of lupus vulgaris is diverse and not always diagnostic. TB of the breast-tuberculosis mastitis-is difficult to recognize and frequently misdiagnosed as breast cancer. Breast involvement is a result of retrograde lymphatic extensions from underlying mediastinal, parasternal, axillary, or cervical lymph nodes. Tuberculids are a group of cutaneous conditions occurring in the presence of TB but containing no stainable or culturable acid- fast bacilli (AFB); based on histopathology, then, they were previously regarded as an allergic reaction to the infection. Monoclonal antibody assays and the PCR technique have become increasingly useful clinically. Treatment of lupus vulgaris with isoniazid alone has resulted in high cure rates. Combination chemotherapy is recommended for patients with extracutaneous disease and multiple skin lesions and for those with profound immunosuppression.

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26

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Figures

Image of Figure 1.
Figure 1.

Paronychia in a pathology resident after performing an autopsy on a patient with unsuspected TB. Reprinted with permission from ( ).

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26
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Image of Figure 2.
Figure 2.

Draining ulcerative lesion over dorsum of the left hand associated with tuberculous osteomyelitis of the fourth and fifth metacarpals. Reprinted with permission from ( ).

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26
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Image of Figure 3.
Figure 3.

Shallow (10-cm) draining ulcer extending from the anorectal line in a patient with external pulmonary TB. Reprinted with permission from ( ).

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26
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Image of Figure 4.
Figure 4.

Typical lesion of lupus vulgaris on a patient whose skin biopsy specimen grew .

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26
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References

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1. Angus, B. J.,, Y. Yates,, C. Conlon,, and I. Byren. 2001. Cutaneous tuberculosis of the penis and sexual transmission of tuberculosis confirmed by molecular typing. Clin. Infect. Dis. 33:132134.
2. Antonori, S.,, L. Galimberti,, G. L. Tudini,, A. L. Ridolfo,, C. Parravicini,, R. Esposoto,, and M. Morini. 1995. Mycobacterium tuberculosis in AIDS patients. Eur. J. Clin. Microbiol. Infect. Dis. 14:911914.
3. Baselga, E.,, M. A. Bernadas,, N. Margall,, and J. M. deMorgas. 1996. Detection of M. tuberculosis complex DNA in a lesion resembling sarcoidosis. Clin. Exp. Dermatol. 21:235238.
4. Bateman, D. E.,, W. Makepeace,, and M. Lensa. 1980. Miliary tuberculosis in association with chronic cutaneous tuberculosis. Br. J. Dermatol. 103:557561.
5. Benjamin, R. G.,, and T. M. Daniel. 1982. Serodiagnosis of tuberculosis using the enzyme-linked immunoabsorbent assay (ELISA) of antibody to Mycobacterium tuberculosis antigen-5. Am. Rev. Respir. Dis. 126:10131016.
6. Beyt, Jr., B. E.,, D. W. Ortbals,, D. J. Santa Cruz,, G. S. Kobayashi,, A. Z. Eisen,, and G. Medoff. 1981. Cutaneous mycobacteriosis: analysis of 34 cases with a new classification of the disease. Medicine 60:95109.
7. Bjornstad, R. 1947. Tubercular primary infection of genitalia: two case reports of venereal genital tuberculosis. Acta Dermatol. Venereol. 27:106.
8. Bruck, C.,, and A. W. Carlson. 1964. Treatment of lupus vulgaris with INH exclusively. Acta Dermatol. Venereol. 44:223225.
9. Caplan, S. E.,, and C. L. Kauffman. 1996. Primary inoculation tuberculosis after immunotherapy for malignant melanoma with BCG vaccine. J. Am. Acad. Dermatol. 35:783785.
10. Cohen, C. 1977. Tuberculosis mastitis. A review of 34 cases. S. Afr. Med. J. 52:1214.
11. Corbett, E. L.,, I. Crossley,, K. M. DeCock,, and R. F. Miller. 1995. Disseminated cutaneous Mycobacterium tuberculosis infection in a patient with AIDS. Genitourin. Med. 71:308310.
12. Daikos, G. L.,, R. B. Uttamchandani,, C. Tuda,, M. A. Fischl,, N. Miller,, T. Cleary,, and M. J. Saldana. 1998. Disseminated miliary tuberculosis of the skin in patients with AIDS: report of four cases. Clin. Infect. Dis. 27:205208.
13. Daniel, T. M.,, R. G. Benjamin,, S. M. Debanne,, Y. Ma,, and E. A. Balestrino. 1985. ELISA of IgG antibody to M. tuberculosis antigen 5 for serodiagnosis of tuberculosis. Indian J. Pediatr. 52:349355.
14. Deluca, M. 1951. Skin tuberculosis. Etiology, pathogenesis, histology, classification. Rass. Int. Clin. Ter. 31:335340.
15. Dinning, W. J.,, and S. Marston. 1985. Cutaneous and ocular tuberculosis: a review. J. R. Soc. Med. 78:576581.
16. Duncan, W. C. 1968. Cutaneous mycobacterial infections. Tex. Med. 64:6670.
17. Engleman, W. R.,, and F. J. Putney. 1972. Tuberculosis of the tongue. Trans. Am. Acad. Ophthalmol. Otolaryngol. 76:13841386.
18. Fine, R. M.,, and H. D. Meltzer. 1970. Psoriasiform lupus vulgaris: a case report. Int. J. Dermatol. 9:273277.
19. Fisher, I.,, and M. Orkin. 1966. Primary tuberculosis of the skin. JAMA 195:314316.
20. Fisher, J. R. 1977. Miliary tuberculosis with unusual cutaneous manifestations. JAMA 238:241242.
21. Forstrom, L. 1969. Carcinomatous changes in lupus vulgaris. Ann. Clin. Res. 1:213219.
22. Forstrom, L. 1969. Isoniazid treatment of lupus vulgaris. A long-term follow-up study. Ann. Clin. Res. 1:3639.
23. Goette, D. K.,, K. W. Jacobson,, and D. R. Doty. 1978. Primary cutaneous inoculation tuberculosis of the skin. Arch. Dermatol. 114:567569.
24. Handwerger, S.,, D. Mildvan,, R. Senie,, and F. W. McKinley. 1987. Tuberculosis and the acquired immunodeficiency syndrome at a New York City Hospital: 1978–1985. Chest 91:176180.
25. Harrison, P. V.,, and J. M. Marks. 2006. Lupus vulgaris and cutaneous lymphoma. Clin. Exp. Dermatol. 5:7376.
26. Heilmaa, K. M.,, and C. Muschenheim. 1978. Primary cutaneous tuberculosis of the skin. Arch. Dermatol. 273:10351036.
27. Heycock, J. B.,, and T. C. Noble. 1961. Four cases of syringe-transmitted tuberculosis. Tubercle 42:2527.
28. Hole, L. E. 1913. Tuberculosis acquired through ritual circumcision. JAMA 61:99102.
29. Hoyt, E. M. 1981. Primary inoculation tuberculosis. JAMA 245:15561557.
30. Izumi, A. K.,, and J. Matsunaga. 1982. BCG vaccine-induced lupus vulgaris. Arch. Dermatol. 118:171172.
31. Kennedy, C.,, and G. K. Knowles. 1975. Miliary tuberculosis presenting with skin lesions. Br. Med. J. 3:356.
32. Koch, M. L.,, and R. H. Cote. 1965. Comparison of fluorescence microscopy with Ziehl-Neelsen stain for demonstration of acid-fast bacilli in smear preparations and tissue sections. Am. Rev. Respir. Dis. 91:283284.
33. Kramer, F.,, S. Sasse,, J. Simms,, and J. M. Leedom. 1993. Primary cutaneous tuberculosis after a needlestick injury from a patient with AIDS and undiagnosed tuberculosis. Ann. Intern. Med. 119:594595.
34. Lee, S. M.,, S. K. Hann,, S. Chun,, and Y. K. Park. 1994. An unusual form of skin tuberculosis following B.C.G. vaccination. J. Dermatol. 21:106110.
35. Lenzini, L.,, P. Rottoli,, and L. Rottoli. 1977. The spectrum of human tuberculosis. Clin. Exp. Immunol. 27:230237.
36. Libraty, D. H.,, and T. F. Byrd. 1996. Cutaneous miliary tuberculosis in the AIDS era: case report and review. Clin. Infect. Dis. 23:706710.
37. Lipper, S.,, D. L. Watkins,, and L. B. Kahn. 1980. Nongranulomatous septic vasculitis due to miliary tuberculosis: a pitfall in diagnosis for the pathologist. Am. J. Dermatopathol. 2:7174.
38. Maguire, A. 1968. Lupus marinus: the discovery, diagnosis and treatment of seventeen cases of lupus marinus. Br. J. Dermatol. 80:213219.
39. Margall, N.,, E. Baselga,, P. Coll,, M. A. Barnadas,, J. M. deMoragas,, and G. Prats. 1996. Detection of Mycobacterium tuberculosis complex DNA by the polymerase chain reaction for rapid diagnosis of cutaneous tuberculosis. Br. J. Dermatol. 135:231236.
40. Martin, A. R.,, and E. J. Mark. 1972. Case 43-1972—granulomatous disease in a man from Honduras. N. Engl. J. Med. 287:872878.
41. McAndrew, P. G.,, E. O. Adekeye,, and A. B. Ajdukiewicz. 1976. Miliary tuberculosis presenting with multifocal oral lesions. Br. Med. J. 1:1320.
42. McCray, M. K.,, and N. B. Esterly. 1981. Cutaneous eruption in congenital tuberculosis. Arch. Dermatol. 117:460464.
43. Michelson, H. E. 1924. Scrofuloderma gummosa (tuberculosis colliquativa). Arch. Dermatol. 10:565578.
44. Minkowitz, S.,, I. J. Brandt,, Y. Rapp,, and C. B. Radlauer. 1969. “Prosector’s Wart” (cutaneous tuberculosis) in a medical student. Am. J. Clin. Pathol. 51:260263.
45. Montgomery, H. 1937. Histopathology of various types of cutaneous tuberculosis. Arch. Dermatol. Syph. 35:698715.
46. Mukerjee, P.,, R. V. Cohen,, and A. H. Niden. 1971. Tuberculosis of the breast. Am. Rev. Respir. Dis. 104:661667.
47. Munt, P. W. 1972. Miliary tuberculosis in the chemotherapy era: with a clinical review of 69 American adults. Medicine 51:139155.
48. Nassau, E.,, E. R. Parsons,, and G. D. Johnson. 1976. The detection of antibodies to Mycobacterium tuberculosis by micro-plate enzyme-linked immunosorbent assay (ELISA). Tubercle 57:6770.
49. Nepomuceno, O. R.,, J. F. O’Grady,, S. W. Eisenberg,, and H. E. Bacon. 1971. Tuberculosis of the anal canal: report of a case. Dis. Colon Rectum 14:313316.
50. Nyfors, A. 1968. Lupus vulgaris, isoniazid and cancer. Scand. J.Respir. Dis. 49:264269.
51. O’Donnell, T. F.,, P. F. Jurgenson,, and N. H. Weyerich. 1971. An occupational hazard—tuberculosis paronychia. Arch. Surg. 103:757758.
52. Pereira, C. A.,, B. Webber,, and J. M. Orson. 1976. Primary tuberculosis complex of the skin. JAMA 235:942.
53. Platou, R. V.,, and R. A. Lennox. 1956. Tuberculosis cutaneous complexes in children. Am. Rev. Tuberc. 74(2 Pt. 2):160169; discussion, 169172.
54. Quiros, E.,, M. C. Maroto,, A. Bettinardi,, I. Gonzalez,, and G. Piedrola. 1996. Diagnosis of cutaneous tuberculosis in biopsy specimens by PCR and southern blotting. J. Clin. Pathol. 49:889891.
55. Reitbrock, R. C.,, R. P. M. Dahlmans,, F. Smedts,, P. J. Frantzen,, R. J. Koopman,, and J. W. VanderMeer. 1991. Tuberculosis cutis miliaris dissemination as a manifestation of miliary tuberculosis. A literature review and report of a case of recurrent skin lesions. Rev. Infect. Dis. 12:265269.
56. Rytel, M. W.,, E. S. Davis,, and K. J. Prebil. 1970. Primary cutaneous inoculation tuberculosis. Am. Rev. Respir. Dis. 102:264267.
57. Sahn, S. A.,, and D. J. Pierson. 1974. Primary cutaneous inoculation drug-resistant tuberculosis. Am. J. Med. 57:676678.
58. Schaefer, G. 1955. Tuberculosis of the breast, a review with the additional presentation of ten cases. Am. Rev. Tuberc. 72:810824.
59. Schein, P. S.,, and H. R. Vickers. 1972. Lupus vulgaris and Hodgkins disease. Arch. Dermatol. 105:244246.
60. Schmidt, C. L.,, M. Ho,, and J. R. Pomeranz. 1976. Lupus vulgaris: recovery of living tubercle bacilli 35 years after onset. Cutis 18:221223.
61. Sehgal, V. N.,, M. K. Jani,, and G. Srivastavia. 1989. Changing patterns of cutaneous tuberculosis. Int. J. Dermatol. 28:231236.
62. Sehgal, V. N.,, G. Srivastavia,, V. K. Khurana,, E. Bhalla,, and P. C. Beohar. 1987. An appraisal of epidermologic, clinical, bacteriologic, histopathologic, and immunologic parameters in cutaneous tuberculosis. Int. J. Dermatol. 26:521526.
63. Sehgal, V. N.,, and S. A. Wagh. 1990. Cutaneous tuberculosis: current concept. Int. J. Dermatol. 29:237252.
64. Senturk, N.,, S. Sahin,, and T. Kocagoz. 2002. Polymerase chain reaction in certain tuberculosis: is it a reliable diagnostic method in paraffin-embedded tissue? Int. J. Dermatol. 41:863866.
65. Shaw, N. M.,, and A. K. Basu. 1970. Unusual cold abscesses. Br. J. Surg. 57:418422.
66. Shengold, M. A.,, and H. Sheingold. 1951. Oral tuberculosis. Oral Surg. 4:239250.
67. Stevens, C. S.,, and D. E. V. Ploeg. 1981. Lupus vulgaris: a case that escaped diagnosis for twenty-eight years. Cutis 27:510511, 514515, 525.
68. Strand, S. 1946.Tubercular primary lesion on penis—cancer, penis venereal tuberculosis. Acta Dermatol. Venereol. 26:461.
69. Sunderam, G.,, B. T. Mongura,, J. M. Lombardo,, and L. B. Reichman. 1987. Failure of four-drug short course tuberculosis chemotherapy in a compliant patient with human immunodeficiency syndrome (AIDS). Am. Rev. Respir. Dis. 136:14751478.
70. Sunderam, G.,, R. J. McDonald,, T. Maniatis,, J. Oleske,, R. Kapila,, and L. B. Reichman. 1986. Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA 256:362366.
71. Sundt, A. 1925. A case of lupus dissematus (post exanthematic miliary tuberculosis cutis). Br. J. Dermatol. 37:316324.
72. Tan, S. H.,, B. H. Tan,, C. L. Goh,, S. H. Tan,, K. C. Tan,, M. F. Tan,, W. C. Ng,, and W. C. Tan. 1999. Detection of Mycobacterium tuberculosis DNA using polymerase chain reaction in cutaneous tuberculosis. Int. J. Dermatol. 38:122127.
73. Ward, A. S. 1971. Superficial abscesses formation: an unusual presenting feature of tuberculosis. Br. J. Surg. 58:540543.
74. Warin, A. P.,, and E. W. Jones. 1977. Cutaneous tuberculosis of the nose with unusual clinical and histologic features leading to a delay in diagnosis. Clin. Exp. Dermatol. 2:235242.
75. Weaver, R. A. 1987. Tuberculosis of the tongue. JAMA 235:2418.
76. Wilner, G.,, S. A. Nassar,, A. Siket,, and H. A. Azar. 1969. Fluorescent staining for mycobacteria in sarcoid and tubercular granulomas. Am. J. Clin. Pathol. 51:585590.
77. Yamauchi, T.,, J. D. Klein,, and W. F. Fanell. 1973. Tuberculosis of the skin. Am. J. Dis. Child. 125:855856.

Tables

Generic image for table
Table 1.

Classification of cutaneous TB and synonymous terms used previously

Citation: Hill M, Sanders C. 2011. Cutaneous Tuberculosis, p 409-414. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch26

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