ABSTRACT
Tuberculosis cutis orificialis (TCO) is a rare manifestation of cutaneous tuberculosis that is caused by auto-inoculation of mycobacteria in patients with advanced internal tuberculosis. TCO occurs in oral, perianal, or genital mucosa and adjacent skin. The tongue is the most frequently affected site, but the perianal area can also be affected. A 39-year-old male presented with a 4-month history of painful ulcers on the perianal area. The histopathologic findings revealed granulomatous infiltrates composed of epithelioid cells and Langhans-type giant cells in the dermis, and a few acid-fast bacilli noted on Ziehl-Neelsen staining. The polymerase chain reaction (PCR) was positive for Mycobacterium tuberculosis and the chest X-ray showed findings consistent with active pulmonary tuberculosis in both upper lung zones. The skin lesion showed complete resolution 2 months after the start of treatment with antituberculosis agents. We report a case of TCO with perianal involvement in a patient with underlying active pulmonary tuberculosis.
Subject(s)
Adult , Humans , Male , Dermis , Epithelioid Cells , Giant Cells, Langhans , Lung , Mucous Membrane , Mycobacterium tuberculosis , Polymerase Chain Reaction , Skin , Thorax , Tongue , Tuberculosis , Tuberculosis, Cutaneous , Tuberculosis, Pulmonary , UlcerABSTRACT
Tuberculosis cutis orificialis is a rare form of tuberculosis of the mucous membranes and the skin of the orifices due to autoinoculation of mycobacteria from progressive tuberculosis of internal organs. We report herein a case of tuberculosis cutis orificialis in a 43-year-old man. He presented with a 2-year history of a large, painful, non-healing ulcer on the scrotum and perianal area. Histopathologic examination of the perianal ulcer revealed tuberculoid granulomas with Langhans' giant cells in the dermis and numerous acid-fast bacilli in Ziehl-Neelsen stain. Chest roentgenogram disclosed active pulmonary tuberculosis in both upper lung fields. Intradermal test with PPD showed negative result.
Subject(s)
Adult , Humans , Dermis , Giant Cells , Granuloma , Intradermal Tests , Lung , Mucous Membrane , Scrotum , Skin , Thorax , Tuberculosis , Tuberculosis, Pulmonary , UlcerABSTRACT
A tender, non-healing ulcer of 3 months' duration developed on the tongue tip of a 51-year-old male with active pulmonary tuberculosis. Acid-fast bacilli were grown in the tissue and sputum cultures. The patient was anergic to PPD skin test before the treatment and IL-2 productivity was significantly decreased. Sections from the tongue tip showed ulceration, infiltration of neutrophils and tuberculoid granulornas accompanying caseation necroses in the dermis. The ulcer healed after administration of anti-tuberculosis medication for 2 months.
Subject(s)
Humans , Male , Middle Aged , Dermis , Efficiency , Interleukin-2 , Necrosis , Neutrophils , Skin Tests , Sputum , Tongue , Tuberculosis , Tuberculosis, Pulmonary , UlcerABSTRACT
We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.