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IP Indian Journal of Clinical and Experimental Dermatology


A ten year prospective clinicopathological study of cutaneous tuberculosis at a tertiary care hospital in coastal Karnataka


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Author Details: Teerthanath Srinivas, Banavasi S Girisha, Hariprasad Srinivas

Volume : 3

Issue : 1

Online ISSN : 2581-4729

Print ISSN : 2581-4710

Article First Page : 17

Article End Page : 21


Abstract

Cutaneous tuberculosis (CTB) constitutes a minor part of extra pulmonary tuberculosis. It continues to be area of most difficult diagnosis for dermatologist practicing in developing countries due to wider differential diagnosis and difficulty in obtaining a microbial confirmation.
Aim: To study the prevalence, pattern of clinical presentation and their correlation with the histological type of cutaneous tuberculosis in coastal Karnataka.
Material and Method: A prospective study of all clinically suspected cases of CTB visiting the skin and STD outpatient department of a tertiary care hospital in coastal Karnataka, during the period 2005 – 2014 were included in the study. All clinically diagnosed cases of CTB cases were biopsied and further investigated by performing mantoux test, Chest X-ray and sputum culture. The diagnosis of cutaneous tuberculosis was based on the combination of clinical, histopathologic, laboratory features and response to antituberculous therapy.
Result: A total of 62 cases of CTB were identified during the ten year study period. The common age group affected was 50 years and above. Males were most commonly affected than females with M: F ratio of 1.2:1. The most common affected site were lower limb (37.10%) followed by face and neck (24.19%). Clinically majority of the cases presented as plaque lesion (46.77%) followed by sinus (22.58%), ulcer (16.13%), verrucous lesion (11.29%) and papule (3.23%). The most common type of CTB encountered were Lupus vulgaris (35.48%) followed by scrofuloderma (33.8%). Systemic involvement was seen in 29 cases. Mantoux test was positive in 80% of cases and tubercular bacillus was isolated in only 3% of cases. All the clinically diagnosed cases of CTB were confirmed on histopathology and responded well to anti-tubercular therapy.
Conclusion: Lupus vulgaris was the most common type of CTB encountered in coastal Karnataka. The common sites affected were lower limb and buttock followed by back and groin. It is important to recognize the myriad clinical presentations of CTB to prevent missed or delayed diagnoses.

Keywords
: Cutaneous tuberculosis, Lupus vulgaris; Scrofuloderma; Mantoux reactivity