Clinical and epidemiological observations of cutaneous tuberculosis in Larkana, Pakistan

Bhutto, Abdul Manan; Solangi, Aijaz; Khaskhely, Noor M.; Arakaki, Hajime; Nonaka, Shigeo

doi:10.1046/j.1365-4362.2002.01440.x

Cited by 57 publications

(59 citation statements)

References 26 publications

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“…Abdul Mamen and Seneha et al in their studies conducted on cutaneous tuberculosis found lupus vulgaris is the commonest form of cutaneous tuberculosis, while scrofuloderma was prevalent in children. 15,16 Granuloma with vasculitis contributes a minor group of granulomatous dermatoses. They are characterized by inflammatory cells in the vessel wall, endothelial reaction, thrombus formation and fibrin deposition ( Figure 5).…”

Section: Resultsmentioning

confidence: 99%

Granulomatous dermatosis: histopathological study in a tertiary care hospital

Teerthanath

2017

Int J Res Med Sci

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Background: Granulomatous dermatosis shares the histological finding of granuloma formation; it is usually formed because of the persistence of a non-degradable product of active hypersensitivity. The identical histological picture may be produced by several causes, which pose a diagnostic challenge to dermatopathologist, Present study aims at classifying cutaneous granulomatous dermatosis based on the morphology and aetiology of granulomas, and to highlight its significance for specific clinical diagnosis.Methods: A retrospective analysis of skin biopsy was done and cases of cutaneous granulomatous lesions diagnosed on histopathological examination were retrieved for a period of 8 years. Clinical data and diagnosis were retrieved from hospital records. Hematoxylin and eosin stained paraffin sections were reviewed. The morphological pattern of granuloma was classified into sarcoidal, necrotizing, necrobiotic and suppurative granulomas and further aetiological evaluation for the granulomatous dermatosis were done using various special stains like Periodic Acid Schiff stain, Fite-Farraco stain, Gomori methenamine silver stain and acid-fast bacilli stain.Results: A total of 228 cases of cutaneous granulomatous lesion were retrieved; out of these 93cases (40.79%) were sarcoidal granuloma type, 83cases (36.40%) were of suppurative granulomas, 29 cases (12.72%) were of necrobiotic granulomas, 20 cases (8.77%) were necrotizing granuloma and 3 cases (1.32%) had granulomatous dermatitis with vasculitis. Infective aetiology was the commonest cause for granulomatous dermatosis (57.89%), mainly by leprosy, tuberculosis and various fungal infection.Conclusions: Granulomatous dermatosis has significant overlap in histopathological picture of various granulomatous reactions. Morphology alone is seldom specific and cannot be used as diagnostic tool. It is better understood based adequate clinical data, morphology of granuloma, special stains and laboratory workup in arriving at a etiology specific diagnosis for definitive clinical management.

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Section: Resultsmentioning

confidence: 99%

Granulomatous dermatosis: histopathological study in a tertiary care hospital

Teerthanath

2017

Int J Res Med Sci

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“…Lupus vulgaris represents the most common form of cutaneous tuberculosis in Pakistani children and primarily affects the head and neck 1. It may occur following direct inoculation or endogenous spread,2 presenting as a soft painless nodule with a red-brown ‘apple jelly’ appearance on diascopy.…”

Section: Discussionmentioning

confidence: 99%

A painless pigmented pinna lesion

Bhatt

2013

Archives of Disease in Childhood

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A 15-year-old boy presented with a 2-month history of a painless lesion on the right earlobe and multiple neck lumps. He had emigrated from Pakistan 4 years earlier and had received the Bacillus Calmette-Guérin (BCG) vaccine at birth. He denied systemic or respiratory symptoms. On examination, a 14 mm soft painless pigmented lesion on the pinna was noted (figure 1). Multiple discreet lymph nodes were palpable on either side of the neck. A Mantoux test was positive but a chest x-ray was unremarkable. Excision biopsy for histology and culture from the ear and representative lymph node showed multiple caseating granulomata with acid-fast bacilli (AFB) on Ziehl-Neelsen staining. Subsequent culture grew Mycobacterium tuberculosis, which was treated with a 6-month course of antituberculosis treatment, to good effect.

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“…It is a serious public health problem in developing countries (5). Along with the inereased frequency of pulmonary TB.…”

Section: Discussionmentioning

confidence: 99%

Long-lasting Scrofuloderma of Hands and Foot

Karabudak¹,

Doğan²,

Harmanyeri³

2007

Acta Derm Venereol

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Letters to the Editor 91 5//: Cutaneous tuberculosis is a part ofthe small percentage of extrapulmonary forms of tuberculosis (TB). It is caused by Mycohacterittm tuberculosis and M Bovis, and under certain conditions, bacillus Calmette-Guerin (BCG), an attenuated form of M bovis (\, 2). Scrofulodemia is one of the most common form of cutaneous TB. It results from an underlying focus, such as lymph node, bone, joint and/or the subcutaneous tissues with formation of cold abscess and a secondary breakdown ofthe overlying skin (3.4). Here we present an unusual case of scrofuloderma in both hands and the left foot. CASE REPORTA 20-year-old man presented to our elinic with multiple, long-standing, painless erythematous plaques on the hands and left fool, which had resulted in atrophic scarring. There was some oozing areas on the lesions. The patient's history revealed that a purulent skin lesion had developed on the back of his right hand following a mole bite 6 years ago, and this was followed by the development of many plaques on the back ofthe other hand and left foot over a period of 5 years. The lesions persisted despite the use of various antibiotics. He described similar lesions on the hands of his sister, but examination was not possible because she was living in another city.On dermatological examination, he had multiple infiltrated erythematous plaques covered by thin scales on his hands ( Fig. la) and on the medial aspect of his left foot. He was afebrile, and there was no lymphadenopathy. Sputum, stool, and urine cultures were negative. Tuberculin skin test was positive with erythema and induration of 20 mm after 48 h. A complete blood count, hepatic and renal function analyses results were within normal limits. Results of acid-fast staining, atypical mycobacterial and routine fungal cultures, polymerase chain reaction were all negative. Venereal disease research laboratory (VDRL), Treponema pallidum haemagglutination assay (TPHA), anti-human immunodeficiency virus (HIV), anti-hepatitis C virus, HBsAg, IgG. IgA, igM, C-reaetive protein, rheumatoid factor and antistreptolysin O tests were all negative. The patient was immunocompetent. Anon-homogenous infiltration was detected on chest X-ray. Thorax computerized tomography (CT) showed interseptal thickening, infiltration in the right upper and midzones and bronchiectasia, suggestive of pneumonia. <& 2007 Acia Dermam-Vc-ncreologica. ISSN l)O()l-5555 DOI: lt).234t)/OOO15555-OI48No improvement was observed in control thorax CT after the dual antibiotic treatment (cefuroxime axetyl 500 mg 2x1 and clarithromycin 500 mg 2x1 /lO days). Articular bone deformities (first metacarpophalangeal (MCP) ofthe right hand, first and fifth MCP ofthe left hand, and first metatarsophalangeal ofthe left foot) as a result of osteomyelitis were detected by X-ray (Figs Ic and e).Histopathology of a skin biopsy showed a nornial epidermis overlying non-caseating granuloma, composed of centrally located epitheloid cells surrounded by lymphocytes and Langerhan's giant cells in the papil...

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Clinical and epidemiological observations of cutaneous tuberculosis in Larkana, Pakistan

Cited by 57 publications

References 26 publications

Granulomatous dermatosis: histopathological study in a tertiary care hospital

Granulomatous dermatosis: histopathological study in a tertiary care hospital

A painless pigmented pinna lesion

Long-lasting Scrofuloderma of Hands and Foot

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