Cutaneous tuberculosis. Part I: Pathogenesis, classification, and clinical features

Kaul, Subuhi; Kaur, Ishmeet; Mehta, Shilpa; Singal, Archana

doi:10.1016/j.jaad.2021.12.063

Cited by 33 publications

(34 citation statements)

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“…The immune response of CTB is analogous to that of pulmonary TB 15 . In addition to the direct immune response to the bacilli (TH1 immune cascade) leading to granuloma formation, there can be a hyperactive immune response in the form of delayed hypersensitivity to form tuberculid lesions without any resident bacilli 16 …”

Section: Discussionmentioning

confidence: 99%

“…16 The clinical form of CTB depends on the host immunity (high/ low), the bacterial load and virulence (multibacillary/paucibacillary), and the route of inoculation (exogenous/endogenous). 16 Malnutrition, poor health, immunosuppressive drugs, and HIV infection are common risk factors for active and severe disease. 9,13 BCG vaccination is considered to be protective against pulmonary and disseminated TB.…”

Section: Discussionmentioning

confidence: 99%

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Clinicoepidemiological characteristics of cutaneous tuberculosis in 1458 Indian patients: a retrospective analytical study from a tertiary care center

et al. 2022

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Background Tuberculosis (TB) has been one of the most challenging infectious diseases globally. Cutaneous tuberculosis (CTB) accounts for 0.5-2% of extrapulmonary TB and is often missed owing to its varying morphology and paucibacillary nature. Methods In this retrospective analytical study, we share our 22-year experience to describe the clinicoepidemiological features and treatment response of CTB in 1458 Indian patients. In each patient, detailed history was followed by clinical examination, hematological and biochemical investigations, Mantoux testing, chest x-ray, and other specialized investigations to detect coexisting systemic foci. Clinical diagnosis of CTB was confirmed on histopathology/cytology and response to standard antitubercular treatment (ATT). All details were recorded on a predesigned proforma. ResultsOf 1458 eligible patients, 803 were children. The mean disease duration was 15.3 months. Lupus vulgaris (40.4%) was the most common clinical variant, followed by scrofuloderma (32.7%) and lichen scrofulosorum (15.2%). Other variants included tuberculosis verrucosa cutis, gumma, tuberculids, and inoculation TB. Multiple clinical variants were observed in 3.6% of patients. A total of 41.4% of patients had coexistent systemic foci; in lymph nodes (50.4%), lungs (35.6%), bone (10.3%), and abdomen (5.8%). TB foci were also observed at uncommon locations like the eye, central nervous system, and genital organs. Treatment response to ATT was favorable in 99.2%.Interpretation The burden of CTB still persists in developing countries. The diagnosis is often missed due to the wide spectrum of clinical and histological presentations.Awareness among clinicians of varying aspects of CTB is of paramount importance for early diagnosis and management and will significantly prevent morbidity and disease complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinicoepidemiological characteristics of cutaneous tuberculosis in 1458 Indian patients: a retrospective analytical study from a tertiary care center

et al. 2022

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Section: Answersmentioning

confidence: 99%

“…Lupus vulgaris is a chronic and progressive paucibacillary form of cutaneous tuberculosis (CTB) that typically presents as slow growing, asymptomatic, scaly, crusted, reddish brown infiltrative plaques with scarring and central atrophy 12. CTB is an uncommon form of indolent extrapulmonary MTB infection, and has a variety of clinical features 1. MTB causes lupus vulgaris through contiguous, hematogenous, or lymphatic routes from an endogenous tuberculosis focus or through exogenous inoculation routes such as acupuncture, tattooing, injection, or BCG vaccination 12…”

Section: Answersmentioning

confidence: 99%