Cutaneous tuberculosis
From IDWiki
Clinical Presentation
Primarily cutaneous tuberculosis
- Occurs following direct inoculation into skin
- Most commonly on face, hands, or feet
- Inflammatory papule that ulcerates, with regional lymphadenopathy and eventual scarring
Tuberculous verrucosa cutis
- Occurs following traumatic inoculation into skin of a TB-sensitized person
- Appears as a purple to brownish-red wart
- Most common on the knees, elbows, hands, feet, and backside
- Can spontaneously resolve over years
Lupus vulgaris
- Progressive disease characterized by small, well-defined brownish-red nodules
- Described as "apple-jelly" nodules
Scrofuloderma
- Occurs from direct extension of underlying tuberculous osteomyelitis or lymphadenitis
- Can heal spontaneously over years, with scarring
Miliary tuberculosis
- Miliary tuberculosis can disseminate to skin
- Typically appears as small red spots that progress into ulcers or abscesses
Tuberculid
- Likely a hypersensitivity reaction from previous tuberculosis infection
- Presents as a generalized exanthem in healthy patients with no active disease but previous infection
- Subtypes include
- Erythema induratum occurs mostly in women, with nodules on the back of legs that can ulcerate
- Papulonecrotic tuberculid has recurrent crusted papules on the extensor surfaces, buttocks, and trunk that scar over in about 6 weeks
- Lichen scrofulosorum has small follicular papules with underlying active disease
Further Reading
- Cutaneous Manifestation of Tuberculosis. Infect Dis Clin Practice. 2012;20(6):376-383. doi: 10.1097/IPC.0b013e31826412e1
