Tuberculous gummas with sporotrichoid pattern in a 57-year-old female: A case report and review of the literature

Abstract

Sporotrichoid tuberculosis is a rare form of cutaneous tuberculosis; it primarily affects children after a post-traumatic inoculation. The diagnosis is often difficult and based on a set of arguments; it should be considered in any sporotrichoid lesion, especially in tuberculosis endemic countries. The following describes a new case of Mycobacterium tuberculosis skin infection with an unusual sporotrichoid clinical appearance in a healthy woman, emphasizing the diagnostic difficulties with a review of literature.

Sporotrichoid distributed tuberculous panniculitis as a late complication of intravesical bacillus Calmette–Guérin (BCG) immunotherapy

“…miliary tuberculosis) [1]- [3]. Lymphatic dissemination, associated with a sporotrichoid distribution of lesions, is unusual and is more generally observed with non-tuberculous mycobacteria [2] or other microorganisms including sporotrichosis, nocardiosis, leishmania and pyogenic or deep fungal infections [4]. Most reported cases of sporotrichoid tuberculosis are secondary to a primary cutaneous entry point and then spread through the lymphatic system in a linear way, but reverse sporotrichoid spreading forms, emanating from an endogenous source, have also been described [4].…”

Tuberculosis cutánea esporotricoide en la Amazonia peruana: reporte de caso

“…Las lesiones pueden evolucionar durante mucho tiempo y continuarán apareciendo mientras no se inicie tratamiento. Las lesiones cutáneas disminuyen en respuesta al tratamiento específico para tuberculosis, teniendo resolución completa al cabo de cinco meses de terapia antituberculosa; sin embargo, puede darse una rápida evolución a los dos meses de esta terapia (9,14,16) . En nuestro caso la paciente continua en segunda fase de terapia antituberculosa de esquema sensible, con resolución de foco primario y sin evidenciarse nuevas lesiones.…”

Cutaneous Tuberculosis: Clinicopathologic Arrays and Diagnostic Challenges

“…The precise diagnosis is often significantly deferred and delayed, as cutaneous TB is not routinely considered in the differential diagnosis due to the relative paucity of pathogens in lesions and varied clinical manifestations ( Table 1 ) [ 2 , 16 , 19 , 31 – 33 ]. Hence, differential diagnosis is obligatory for the successful clinical management and treatment.…”