Cutaneous Tuberculosis: A 26-Year Retrospective Study in an Endemic Area of Tuberculosis, Vitória, Espírito Santo, Brazil

Abstract

SUMMARY Background: Tuberculosis is a serious health problem in Brazil so that the knowledge on the aspects of cutaneous tuberculosis is medically important. Objective: To assess the characteristics of patients with cutaneous tuberculosis treated at the Cassiano Antonio Moraes University Hospital, located in the city of Vitória, State of Espírito Santo, Brazil. Methods: This is a retrospective, descriptive, observational and cross-sectional study using the medical records of 29 patients with cutaneous tuberculosis treated at the Dermatology and Pulmonology services of the hospital from 1986 to 2011. The inclusion criterion was the confirmation of cutaneous tuberculosis taking into account clinical, epidemiological, immunological, and bacteriological findings, as well as the response to specific treatment. Results: Of the 29 studied patients; 18 (62%) were women with average age of 37 years; the predominant clinical condition was erythema induratum of Bazin in 12 (41.4%) cases; and the cutaneous lesions were in the lower limbs in 19 (65.8%) patients. Extra-cutaneous involvement occurred in eight (27.6%) cases. The tuberculin tests were positive in 15 (79%) individuals and the assessment of the infectious agent was negative in most of the investigated cases. Conclusion: The study found a low frequency (0.44%) of cutaneous tuberculosis in an endemic area of tuberculosis. There was a predominance of infection in women aged thirty to forty years. Erythema induratum was the most common clinical condition, affecting mainly the lower limbs, in contrast to other Brazilian studies that found scrofuloderma as the most common manifestation, predominating in the cervical region of male children and adolescents.

Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

“…times) as well as disseminated TB cases (16.2%, eight times) (the latter calculated only for the last 10 years), contrasting the estimative described in Brazilian literature. 9,10 This difference is most likely explained by the fact that we are a TB reference hospital in Rio de Janeiro state, which has the second highest TB incidence rate in Brazil. 11 Women predominated in our case series, as described in other studies of CTB.…”

“…11 Women predominated in our case series, as described in other studies of CTB. 9,[12][13][14][15] node is the most common presentation of CTB described in the literature in some developing countries. [22][23][24] Similarly, gumma, known as cutaneous abscesses, is also found in large case series of CTB.…”

Tuberculosis cutánea a forma de lupus vulgar causada por vacuna de bacilo Calmette-Guérin. A propósito de un caso pediátrico

“…El LV constituye la forma más frecuente y conocida de tuberculosis cutánea en países industrializados. Mycobacterium tuberculosis es el agente más común, pero también puede estar implicado Mycobacterium bovis y menos frecuentemente el BCG (11) . Esta forma de tuberculosis cutánea predomina en el sexo femenino en una relación 2:1 y se presenta en pacientes con moderado o alto grado de inmunidad como resultado de la diseminación de la micobacteria ya sea por vía hematógena, linfática o por contigüidad (4) .…”

“…Raramente las lesiones se desarrollan sobre el punto de inoculación primaria o por vacunación (3) . Se manifiesta como una o más placas asintomáticas eritemo parduzca de consistencia blanda, que a la discopía muestra el color típico de la jalea de manzana y donde existen micropápulas que se agrupan y coalesen (lupomas o tubérculos) formando un borde sobreelevado y una atrofia central debido a su crecimiento centrífugo (11)(12)(13) . Las lesiones provocadas por diseminación hematógena se localizan frecuentemente en cabeza y cuello, pero pueden afectar miembros y las mucosas oral, nasal o conjuntival por extensión (14) .…”

A 9‐year massive scrofuloderma of the scalp cured in 3 months

“…The progression of the disease is very slow, with subcutaneous nodules, patches, fistula, sinus, ulcers, and scars being found at different stages. Histopathological features are typical granuloma containing caseous necrosis; TB can usually be found inside . Early discovery as well as timely and sufficient treatment of anti‐tuberculosis drugs are the key to cure the disease.…”