A Case of Tuberculosis Verrucosa Cutis Confirmed by Detection of Mycobacterium tuberculosis DNA Using by Polymerase Chain Reaction / 대한피부과학회지

No abstract available.

Tuberculosis verrucosa cutis en niños: Presentación de dos casos y revisión de la literatura / Tuberculosis verrucosa cutis in children: Two cases report and review

La tuberculosis cutánea (TBC) representa el 1.5% de todas las formas de TB extrapulmonares. Es una enfermedad proteiforme y su diagnóstico constituye un reto al clínico. La TB verrucosa cutis (TBVC) es una variante clínica paucibacilar, de TBC, donde es infrecuente aislar en medios de cultivos el Mycobacterium tuberculosis. Ocurre en niños previamente sensibilizados e inmunocompetentes que se reinfectan con este bacilo de una fuente exógena, algunas veces de un esputo o secreción de un paciente con TB activa, cuando juega en la tierra. La bacteria penetra a la piel a través de pequeñas abrasiones en zonas expuestas a traumas como lo son rodillas, tobillos o glúteos. La lesión se inicia como un papulonódulo verrucoso asintomático, parecido a una verruga común, que evoluciona a una placa verrucosa . Reportamos 2 casos de TBVC, una niña de 6 años de edad y el segundo, un niño de 10 años de edad ambos de la comarca Guna Yala, un área con alta prevalencia de TB en Panamá. En el segundo caso se logró aislar el M. Tuberculosis en medios de cultivo y demostrarse además por la reacción en cadena de la polimerasa (PCR). La respuesta a la terapia antituberculosa fue exitosa, en ambos casos, con completa regresión de las lesiones a los 2 meses de tratamiento

Cutaneous tuberculosis (CTB) comprises 1.5% of all extrapulmonary TB forms. It is a proteiform disease and its diagnosis represents a challenge to the clinician. TB verrucosa cutis (TBVC) a paucibacillary clinical manifestation of CTB, where routine cultures for Mycobacteriun tuberculosis, are commonly negative. Occurs in children previously sentitized with a moderate to high degree of immunity. It represents an exogenous reinfection of M. tuberculosis, sometimes from a contaminated sputum of a patient with active TB, at sites prone to minor abrasions, such as, knees, ankles or buttocks. The lesion begins as a solitary asymptomatic verrucous papulonodule, similar to a common wart, that evolves to a verrucous plaque. The author report 2 cases of TBVC, a 6 year old girl and the second one, a 10 year old boy, both from Guna Yala, an indigenous region, o the coast of Panama, an area with a high prevalence of TB. In the second case, M. tuberculosis was isolated in routine cultures and reported positive in Polimerase chain reaction (PCR). The antituberculous therapy was successfull in both patients, with complete regression of the lesions after 2 months of treatment

Tuberculosis Verrucosa Cutis in an 11-year-old girl: A case report

@#We report a case of an 11-year-old girl who presented with a gradually enlarging verrucous plaque on the left knee for 3 years. Physical examination showed a solitary, slightly erythematous, scaly, verrucous plaque on the left knee measuring about 1.5 cm x 2 cm. Biopsy revealed granulomatous dermatitis consistent with cutaneous tuberculosis. A diagnosis of tuberculosis verrucosa cutis (TBVC) was made and anti-tuberculous therapy was initiated consisting of rifampicin, isoniazid, pyrazinamide and ethambutol for 2 months followed by rifampicin and isoniazid for 4 months. Upon completion of therapy, only a slightly atrophic scar remained, supporting our diagnosis. This report highlights TBVC must be considered in patients with chronic skin lesions in countries with high prevalence of tuberculosis.

Tuberculosis Verrucosa Cutis Confirmed by Culture / 대한피부과학회지

Tuberculosis verrucosa cutis is a warty form of cutaneous tuberculosis. It is a paucibacillary disorder caused by external reinfection of mycobacteria into the skin of previously sensitized individuals with moderate to strong cell-mediated immunity. Inoculation arises at sites of minor wounds, or rarely from the patient's sputum. Tuberculosis verrucosa cutis begins as a small papule and grows slowly by peripheral expansion, sometimes reaching a size of several centimeters or more in diameter. For definitive diagnosis of cutaneous tuberculosis, the demonstration of Mycobacterium tuberculosis is essential. However, the laboratory diagnosis of paucibacillary cutaneous tuberculosis is very difficult owing to the poor sensitivity of routine available methods. Herein, we report two cases of tuberculosis verrucosa cutis definitively confirmed by mycobacterial culture in Korean patients who had received bacille Calmette-Guerin vaccination earlier in life.

A Case of Tuberculosis Verrucosa Cutis with Ulcer in a Patient with Pulmonary Tuberculosis / 대한피부과학회지

No abstract available.

Tuberculosis Verrucosa Cutis in a Patient with Pulmonary Tuberculosis / 대한피부과학회지

Tuberculosis verrucosa cutis is a common form of cutaneous tuberculosis. Most cases of tuberculosis verrucosa cutis appear as secondary infections of skin, however concomitant primary internal organ involvement rarely occurs. To our knowledge, only three cases of coexistence of tuberculosis verrucosa cutis and pulmonary tuberculosis have been reported in literatures to date. We report on another case of tuberculosis verrucosa cutis, which occurred in a middle-aged, Korean woman with pulmonary tuberculosis, and review the literatures.

A Case of Giant Tuberculosis Verrucosa Cutis Associated with Bladder Cancer / 대한피부과학회지

Tuberculosis verrucosa cutis (TVC) is one of the most common forms of cutaneous tuberculosis in Asia. It occurs as a result of inoculation of mycobacteria into the skin of an individual who has previously been infected and who has a moderate-to-high degree of immunity. Although the chronic nature of tuberculosis verrucosa cutis is well known, we report an unusual case of rapid spreading of giant tuberculosis verrucosa cutis which had been present for 1 year in a 41-year-old man with bladder cancer-transitional cell carcinoma.

Role of fine needle aspiration cytology of lymphnodes in the diagnosis of cutaneous tuberculosis.

Background: Lymph node involvement in cutaneous tuberculosis is primarily seen in patients with Scrofuloderma. However, patients with lupus vulgaris and TBVC sometimes present with regional lymphadenopathy. Demonstration of organism in skin biopsies by ZN stain and culture is time consuming and often unrewarding when bacillary load is considerably low. Fine needle aspiration cytology (FNAC) is an economical, dependable, quick and cost effective tool for an early diagnosis compared to biopsy studies. Aim: The present study was undertaken to assess the utility of FNAC of lymphnodes in diagnosis of cutaneous tuberculosis. Method: FNAC of affected lymph nodes in Scrofuloderma and lymph nodes draining the lesions in TBVC and lupus vulgaris was carried out followed by skin biopsy in 26 patients of clinically suspected cases of cutaneous tuberculosis. Observations: Smears revealed epithelioid cell granulomas over a necrotic background. AFB could not be demonstrated by ZN stain. Histopathological studies of skin biopsies revealed epithelioid cell granulomas and Langhans’ giant cells. Biopsies were also negative for AFB by ZN stain and culture. All the patients responded well to standard antituberculous regimen. Conclusions: FNAC of lymph nodes in cases of cutaneous tuberculosis is a useful procedure that helps in arriving at diagnosis within a reasonable time frame.

A Case of Tuberculosis Verrucosa Cutis Diagnosed by Using Polymerase Chain Reaction / 대한피부과학회지

For a definitive diagnosis of cutaneous tuberculosis, the demonstration of the mycobacteria is essential, but routinely available methods such as AFB stain and culture have poor sensitivity and are time-consuming. Recently, PCR has emerged as a promising tool in the diagnosis of cutaneous tuberculosis due to its high sensitivity and speed. We herein report a case of tuberculosis verrucosa cutis without demonstarable acid-fast bacilli, but diagnosed by using PCR.

A Case of Tuberculosis Verrucosa Cutis / 대한피부과학회지

We report a case of tuberculosis verrucosa cutis in a 39-year-old male patient, who presented verrucous plaque on the dorsum of right third finger. Seven months ago, he had a cut with paper and skin lesion developed. Histopathologic features revealed parakeratosis, irregular acanthosis in the epidermis and inflammatory cellular infiltrates and tuberculoid granulomas in the dermis. AFB- positive bacilli were demonstrated. He has been treated with isoniazid, rifampicin, ethambutol, and pyrazinamide for 4 months till now and the skin lesion has been markedly improved.

A Case of Tuberculosis Verrucosa Cutis / 대한피부과학회지

We report a case of tuberculosis verrucosa cutis in a 64-year-old male patient, who had multiple verrucous plaques on his right hand for twenty years. His past history revealed a previous history of injury on his lesion site. Histologic features consisted of hyperkeratosis, acanthosis in the epidermis with inflammatory infiltrate and tuberculoid granuloma in the dermis. It was suspected that the patient had tuberculosis verrucosa cutis, but no bacilli was found in the lesion in the AFB stain. Then we performed PCR, which showed a positive result. We started antituberculosis medication, and the lesions cleared up after 6 months of treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol. The lesions were later confirmed to be tuberculosis by the AFB culture. We suggest that early diagnosis of tuberculosis verrucosa cutis can be made by using PCR.

A Case of Tuberculosis Verrucosa Cutis / 대한피부과학회지

Tuberculosis verrucosa cutis is caused by the external inoculation of Mycobacterium tuberculosis into the skin of a person who already has a significant degree of cell mediated immunity to this organism. This form of cutaneous tuberculosis is less common. A 29-year-old male had a solitary adult palm sized, verrucous surfaced scaly plaque for about 10 years. The lesion was excised about 10 years ago but gradually increased in size. At first we suspected a deep mycosis and treated him with anti-fungal medication for 3 months. However, the skin lesion did not improve. He was then treated with anti-tuberculosis medication for 9 months under the impression of tuberculosis verrucosa cutis. The skin lesion was almost healed and no recurrence has been observed for 8 months after the treatment.

A Case of Tuberculosis Verrucosa Cutis / 대한피부과학회지

We report a case of tuberculosis verrucosa cutis in a 35-year-old male patient who presented itchy verrucous plaque over both buttocks. Skin biopsy revealed hyperkeratosis, parakeratosis, and irregular acanthosis in the epidremis, and inflammatory infiltration and noncaseating tuberculoid granulomas in the dermis. Several AFB-positive bacilli were detected. He was treated with isoniazid, rifampicin, ethambutol, and pyrazinamide for 4 months till now and the verrucous skin lesions have been markedly improved.

A Cases of Cutaneous Metastasis Probably Originating From Stomach Carcinoma / 대한피부과학회지

Cutaneous metastases from internal carcinornas are relatively rare. The frequency of metastases to the skin varies from 0.5-4.4%. We report a case of cutaneous metastasis suspected to originat from stomach cancer. A 44-year-old female, who had an episode of total gastrectony under diagnosis of stornach cancer three years ago, had multipe painless erythernatous nodules on the case and neck for one year. Histologic findings shows atypical anaplastic cell infiltration at the derr is and subcutaneous tissues. Cells with hyperchrornatic and erally displaced nuclei were recogniz d PAS staining shows positive reactions within the cells of glarid like structure. She died twelve month after the appearance of the cutaneous lesions.

A case of tuberculosis verrucosa cutis / 대한피부과학회지

We report a case of tuberculosis verrucosa cutis in a 34-year-old male patient who presented with asymptomatic verrucous plaque over the right buttock, right inner thigh and right inguinal area. The Mantoux test revealed a strong positive reaction. The histologic picture consists of hyperkeratosis, acanthosis and papillomatosis overlying an inflammatory infiltrate in the upper dermis. Tuberculoid granulomas without caseation necrosis are seen in the dermis. Tubercle hacilli were not demonstrated. The patient was treated with INAH, Rifampicin and Ethambutol for 6 months. To date, the skin lesions have markedly improved.