Miliary tuberculosis in association with chronic cutaneous tuberculosis

Abstract

A case of miliary tuberculosis associated with two different forms of cutaneous tuberculosis and a negative Heaf tuberculin test is reported. The value of skin biopsy and culture in helping to establish an early diagnosis is discussed. The unusual finding of a negative Heaf tuberculin test is commented upon.

Verrucous tuberculid mimicking Kyrle disease

“…LV postexanthematicus is characterized by erythematous papules, plaques, nodules and rarely verrucous lesions due to hematogenous dissemination following transient immunosuppression induced by a viral exanthem like measles or chickenpox or enteric fever 13 . Acute miliary tuberculosis and tuberculous gumma occur in the background of severe immunosuppression 14 . The patients are gravely ill and tuberculin test is usually negative.…”

Tuberculosis Cutis Miliaris Disseminata as a Manifestation of Miliary Tuberculosis: Literature Review and Report of a Case of Recurrent Skin Lesions

“…The characteristics of these cases are given in table 1. In two cases (10 and 21) no biopsies were performed, and in five cases (7,11,12,23, and 24) no acidfast bacilli were demonstrated; thus a meaningful evaluation of these seven cases is impossible. In the left upper leg (seen on the right here) is an ab scess (*) extending along the musculus biceps femoris.…”

“…Histologic examina tion shows a nonspecific dermal infiltrate of lymphocytes and plasma cells, with focal areas of necrosis and abscess (usu ally without granuloma formation) in which acid-fast bacilli are found [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Granuloma formation seems to be depen dent on the presence of vascular thrombi with acid-fast bacilli, which interrupt the local blood supply.…”

“…Through a computer search of the literature (Medlars), we found reports on 24 cases of tuberculosis cutis miliaris dis seminata [1,2,[4][5][6][7][8][9][10][11][12][13][14]. The characteristics of these cases are given in table 1.…”

“…Recurrences were not described, with the possible excep tions of cases 14 and 17 [1,2,[9][10][11][12][13]. In case 14 new lesions appeared every few weeks despite repeated courses of strep tomycin and /^-aminosalicylic acid; after 2 years, isoniazid was given, and no additional lesions developed subsequently.…”