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2.
An. bras. dermatol ; 96(2): 228-230, Mar.-Apr. 2021. graf
Article in English | LILACS | ID: biblio-1248737

ABSTRACT

Abstract As the treatment of infectious and parasitic diseases improved, the prevalence of these conditions declined. However, with the expansion of the use of immunobiologicals, opportunistic infections have emerged, especially under atypical presentations. The present study reports the case of a patient treated with infliximab for Crohn's disease, who presented diarrhea, weight loss, abdominal pain, fever, and subcutaneous erythematous nodules that evolved with spontaneous fluctuation and ulceration. With the finding of alcohol-resistant bacilli and Mycobacterium tuberculosis DNA in a cutaneous fragment, through polymerase chain reaction, the diagnosis of gummatous tuberculosis was confirmed, probably secondary to hematogenous dissemination from an intestinal focus.


Subject(s)
Humans , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/chemically induced , Tuberculosis, Cutaneous/drug therapy , Crohn Disease/drug therapy , Syphilis , Skin , Infliximab/adverse effects
3.
An. bras. dermatol ; 96(1): 82-84, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152789

ABSTRACT

Abstract Cutaneous tuberculosis is a rare infection that is difficult to diagnose, because it shows less sensitivity and specificity in classic complementary exams when compared with the pulmonary form. The Xpert MTB/RIF® method offers an early diagnosis that identifies the DNA of Mycobacterium tuberculosis and the main mutations that give the bacterium resistance to rifampicin. The authors present a case of scrofuloderma whose diagnosis was quickly obtained through the secretion of a cervical lesion, allowing an early diagnosis and the initiation of appropriate treatment.


Subject(s)
Humans , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Antibiotics, Antitubercular/therapeutic use , Antibiotics, Antitubercular/pharmacology , Mycobacterium tuberculosis/genetics , Rifampin/therapeutic use , Sensitivity and Specificity , Drug Resistance, Bacterial , Lymph Nodes
4.
Braz. j. infect. dis ; 25(3): 101593, 2021. graf
Article in English | LILACS | ID: biblio-1339428

ABSTRACT

ABSTRACT Tuberculosis verrucosa cutis is a rare medical condition that is caused by the inoculation of Mycobacterium tuberculosis into the skin of a previously sensitized individual. This clinical form of tuberculosis corresponds to 1-2% of all cases of tuberculosis and due to the paucibacillary characteristic of the lesions, patients can be misdiagnosed, accounting for the chronification of the skin infection. Herein, we report the case of a 26-year-old male farmer, presenting plaques with verrucosa and hyperkeratosis features in the left thigh and buttocks during 15 years. M. tuberculosis was identified by PCR and the patient was treated with standard anti-tuberculosis drugs, with subsequent improvement of the skin lesions.


Subject(s)
Humans , Male , Adult , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Mycobacterium tuberculosis/genetics , Skin , Brazil , Antitubercular Agents/therapeutic use
6.
Rev. méd. Urug ; 35(2): 155-164, jun. 2019. fig
Article in Spanish | LILACS | ID: biblio-999629

ABSTRACT

La tuberculosis cutánea es una enfermedad infecciosa crónica y poco frecuente ocasionada por Mycobacteriun tuberculosis. Existen varias formas de la infección cutánea, siendo el lupus vulgar la más frecuente y común en los países industrializados. Las variantes clínicas dependerán de la vía de llegada del bacilo a la piel, del estado inmunológico del paciente y del medio ambiente. En el lupus vulgar, además de M. tuberculosis puede estar implicado M. bovis y menos frecuentemente el bacilo de Calmette y Guérin. Esta entidad presenta una evolución crónica, es de carácter progresivo y es rara de ver en niños. Se presenta el caso de una niña en la cual se diagnosticó una forma de tuberculosis cutánea denominada lupus vulgar provocada por el bacilo de Calmette y Guérin. Caso clínico: niña de 10 años que presentaba lesiones cutáneas de diferentes características, de evolución tórpida y asintomáticas; la de mayor tamaño se localizaba en la cara externa del deltoides derecho en forma de placa eritematosa de 20 por 10 cm con bordes sobreelevados presentando en su centro micropápulas que coalescen dejando una zona de atrofia central. Esta había comenzado en etapa neonatal luego de la vacunación por el bacilo de Calmette y Guérin. Desde hacía tres años presentaba una segunda lesión más pequeña en cara externa de muslo derecho de similares características y otras de carácter múltiple en dorso con forma de micropápulas rojo vinosas. Los exámenes de valoración general fueron normales, al igual que la radiografía de tórax y de los miembros. El test de la tuberculina mostró una induración de 15 mm y las baciloscopias fueron negativas. La biopsia de la lesión de piel del deltoides mostró granulomas caseosos y las técnicas moleculares diagnosticaron Mycobacterium bovis atenuado. Con ese diagnóstico, recibió tratamiento antituberculoso por diez meses con buena tolerancia y con mejoría de las lesiones.


Cutaneous TB is a rather unusual chronic infectious disease caused by Mycobacteriun tuberculosis. There are several forms of cutaneous infection, lupus vulgaris being the most frequent and ordinary one in developed countries. Clinical variations will depend on the site of infiltration of the skin by the bacillus, the patient's immune condition and the environment. In the case of lupus vulgaris, apart from Mycobacteriun tuberculosis, M. bovis may be involved, and the Bacille Calmette Guérin involvement is less frequent. The latter presents a chronic evolution, being progressive and unusual in children. The study presents the case of a girl who was diagnosed with a form of cutaneous tuberculosis called lupus vulgaris caused by the Bacille Calmette-Guérin vaccine. Clinical case: a 10 year old girl who evidenced skin lesions of different kinds, of slow evolution and asymptomatic: the largest one was in the external part of the right deltoid muscle as an erythematous plaque of 20 by 10 cm with higher borders evidencing micro papules in the center that coalesce leaving a central atrophy zone. The latter had started in the neonatal stage after the Bacille Calmette-Guérin vaccine. For three years she had evidenced a second smaller lesion in the outer face of the right thigh of similar characteristics and other multiple lesions in the back with the shape of vinous red micro papules. Assessment tests were generally normal, as well as the chest and limbs X-ray. The tuberculin test evidenced a 15 mm induration and smears were negative. The deltoid muscle skin lesion biopsy showed caseous granulomas and molecular techniques diagnosed attenuated Mycobacteriumbovis. Given that diagnose the patient received anti-TB treatment during 10 months, tolerance being good and the lesions improved.


A tuberculose cutânea é uma doença infecciosa crônica e pouco frequente causada pelo Mycobacteriun tuberculosis. Existem várias formas de infecção cutânea, sendo o lúpus vulgar a mais frequente e comum nos países industrializados. As variantes clínicas dependerão da via de entrada do bacilo à pele, do estado imunológico do paciente e do ambiente. No lúpus vulgar, além do M. tuberculosis podem estar implicados o M. bovis e mais raramente o bacilo de Calmette-Guérin. Esta entidade apresenta uma evolução crônica, é progressiva e é rara em crianças. Apresenta-se o caso de uma paciente de sexo feminino com 10 anos que foi diagnosticada com uma forma de tuberculose cutânea denominada lúpus vulgar provocada pelo bacilo de Calmette-Guérin. Caso clínico: paciente de sexo feminino com 10 anos que apresentava lesões cutâneas de diferentes características, com evolução letárgica e assintomática; a maior lesão estava localizada na face externa do deltoide direito sob a forma de placa eritematosa de 20 x 10 cm com bordes sobrelevados apresentando no centro micropápulas que coalescem deixando una zona de atrofia central. Esta lesão começou na etapa neonatal depois da vacinação com o bacilo de Calmette-Guérin. Desde 3 anos apresentava uma segunda lesão menor na face externa da coxa direita com características similares e outras múltiplas no dorso com forma de micropápulas com coloração de manchas em vinho do Porto. Os exames de avaliação geral foram normais, bem como as radiografias de tórax e de membros. O teste da tuberculina mostrou uma induración de 15 mm e as baciloscopias foram negativas. A biopsia da lesão de pele dos deltoides mostrou granulomas caseosos e as técnicas moleculares diagnosticaram Mycobacterium bovis atenuado. Com esse diagnóstico recebeu tratamento antituberculoso por 10 meses com boa tolerância e melhoria das lesões.


Subject(s)
Child , Tuberculosis, Cutaneous/diagnosis , Lupus Vulgaris/diagnosis , BCG Vaccine/adverse effects , Child
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 179-184, jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1014435

ABSTRACT

RESUMEN La tuberculosis cutánea representa menos del 2% de todos los casos de la infección por Mycobacterium tuberculosis. Su baja prevalencia, asociada a la amplia variedad en la presentación clínica de las lesiones, dificulta y retrasa el diagnóstico y, por tanto, el inicio del tratamiento. El siguiente es el caso de una paciente de 80 años, con una lesión ulcerada, crónica, en pabellón auricular izquierdo, con evolución tórpida y pobre respuesta al manejo farmacológico instaurado; con biopsia de piel que mostró reacción inflamatoria crónica y presencia de bacilos ácido-alcohol resistentes.


ABSTRACT Cutaneous tuberculosis represents less than 2% of all cases of infection with Mycobacterium tuberculosis. Its low prevalence, associated with a wide variety in clinical presentation of the lesions, hinders and delays the diagnosis and, thus, treatment initiation. The following is the case of an 80-years old, female patient with an ulcerated, chronic lesion in the left ear auricle, with a torpid evolution and poor response to established pharmacological management; with a skin biopsy that showed chronic inflammatory reaction and the presence of acid-fast bacilli.


Subject(s)
Humans , Female , Aged, 80 and over , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Ear Auricle/pathology , Tuberculosis, Cutaneous/pathology , Ear Auricle/microbiology , Mycobacterium tuberculosis
8.
An. bras. dermatol ; 94(1): 102-104, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-983737

ABSTRACT

Abstract: Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis, comprising 1-2% of cases. Caused by Mycobacterium tuberculosis or related strains, it presents a wide range of clinical manifestations, mimicking other chronic dermatoses and leading to delayed diagnosis. A case of scrofuloderma is reported, whose diagnosis and treatment were only made six years after onset of the disease.


Subject(s)
Humans , Male , Adult , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/pathology , Skin/pathology , Tuberculin Test , Delayed Diagnosis
9.
Rev. chil. dermatol ; 34(3): 89-94, 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-995077

ABSTRACT

Cada día es más habitual ver en nuestra consulta médica enfermedades dermatológicas endémicas de zonas tropicales, gracias a los flujos migratorios recientes y aumento del turismo hacia el extranjero. Presentamos un acrónimo muy utilizado en Brasil, PLECT, que reúne a enfermedades infecciosas que deben tenerse en mente en el diferencial de lesiones verrucosas, a saber, Paracoccidiodomicosis, Leishmaniasis Tegumentar, Esporotricosis, Cromomicosis y Tuberculosis Cutánea.


Increasingly, it is more common to see dermatological diseases that are endemic in tropical areas in our medical practice, thanks to recent migratory flows and increased tourism abroad. We present an acronym widely used in Brazil, PLECT, which brings together infectious diseases that should be borne in mind in the differential of verrucous lesions, namely, Paracoccidiodomicosis, Cutaneous Leishmaniasis, Sporotrichosis, Chromomycosis and Cutaneous Tuberculosis.


Subject(s)
Humans , Skin Diseases, Infectious/diagnosis , Tropical Zone , Paracoccidioidomycosis/diagnosis , Sporotrichosis/diagnosis , Tuberculosis, Cutaneous/diagnosis , Chromoblastomycosis/diagnosis , Leishmaniasis, Cutaneous/diagnosis , Diagnosis, Differential
10.
Rev. Soc. Bras. Med. Trop ; 50(4): 565-567, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-896997

ABSTRACT

Abstract Seven months after undergoing kidney transplantation, a 56-year-old woman presented with papules and ulcers in her right forearm. The patient received antibiotics for 8 months with limited improvement. Eleven months after symptom onset, she presented with acute arthritis in her left knee. Asynovial fluid culture yielded Mycobacterium tuberculosis, and a forearm ulcer biopsy showed granulomatous inflammation. After surgical fistulectomy and 12 months of tuberculosis treatment, she was cured. Chronic cutaneous ulcers and articular manifestations in TB are rare, but they should always be considered in the differential diagnosis for immunosuppressed patients. Surgical intervention and prolonged treatment might be necessary.


Subject(s)
Humans , Female , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Osteoarticular/diagnosis , Kidney Transplantation/adverse effects , Tuberculosis, Cutaneous/surgery , Tuberculosis, Cutaneous/immunology , Tuberculosis, Osteoarticular/surgery , Tuberculosis, Osteoarticular/immunology , Immunocompromised Host , Middle Aged
11.
Rev. chil. dermatol ; 33(2): 52-56, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-964917

ABSTRACT

La tuberculosis cutánea (TC) es una afección infrecuente dentro de la tuberculosis extrapulmonar, siendo su clínica variada e inespecífica. Se presenta el caso de TC: Mujer de 48 años sin antecedentes mórbidos que consultó por lesión cutánea en pabellón auricular y piel circundante, de dos años de evolución, pruriginosa, con aumento de tamaño progresivo y supuración serosa ocasional, al examen se constató placa eritematosa anaranjada, de consistencia blanda. Reacción en Cadena de Polimerasa de biopsia evidenció infección por Mycobacterium tuberculosis, logrando remisión de la lesión con tratamiento antituberculoso establecido en las normas sanitarias de Chile. La TC es una entidad de difícil diagnóstico, incluso contando con cultivos. A causa del aumento de casos de tuberculosis por el incremento de factores inmunosupresores, y a su potencial agresividad sistémica, se recomienda un alto nivel de sospecha.


Cutaneous tuberculosis (CT) is an infrequent condition of extrapulmonary tuberculosis, with a varied and non-specific clinical morphologies. A case of CT is presented: 48-yearold woman with no morbid history, who consulted for a skin lesion in the auricular pavilion and surrounding area, of two years of evolution, pruritic, with increasing progressive size and occasional serous secreation. On physical examination, orange erythematous plaque with soft consistency was found. Polymerase Chain Reaction from biopsy, showed infection by Mycobacterium tuberculosis, achieving remission of the lesion with antituberculosis treatment established in Chilean sanitary regulations. CT is an entity difficult to diagnose even with the use of culture. A high level of suspicion is recommended because of the increase of cases of tuberculosis due to immunosuppressive factors and their potential systemic aggressiveness.


Subject(s)
Humans , Female , Middle Aged , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/pathology , Biopsy , Polymerase Chain Reaction , Diagnosis, Differential , Ear Auricle
12.
Rev. méd. hered ; 27(3): 177-180, jul.-sept. 2016.
Article in Spanish | LILACS, LIPECS | ID: biblio-982880

ABSTRACT

La TBC es una enfermedad causada por Mycobacterium tuberculosis y afecta usualmente el pulmón aunque un pequeño porcentaje se puede presentar en la forma cutánea. Se presenta el caso de un varón de 23 años, natural de la provincia de Madre de Dios, que desarrolló TBC pulmonar y cutánea causado por Mycobacterium tuberculosis MDR. El diagnóstico se hizo por Bk de secreción cutánea y Bk de esputo con resultado positivo en ambos casos; presentó además edema en hemicuerpo izquierdo, y ulceras a nivel esternal y a nivel clavicular. El paciente fue hospitalizado como enfermedad TBC pulmonar y extrapulmonar. El caso reportado pone en énfasis la TBC cutánea y el riesgo que esto significa aun en pacientes inmunocompetentes.


TBC caused by Mycobacterium tuberculosis and affects usually the lung, although a small percentage of patients present with skin involvement. We present the case of a 23-year-old male patient from Madre de Dios who developed both pulmonary and skin TBC caused by multi-drug resistant Mycobacterium tuberculosis. The diagnosis was made by detecting Mycobacterium using acid fast stains in sputum and skin samples. This case illustrates the risk that immunosuppressed patients has to get cutaneous tuberculosis.


Subject(s)
Male , Humans , Young Adult , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Tuberculosis, Multidrug-Resistant
14.
Indian J Dermatol Venereol Leprol ; 2015 Jul-Aug; 81(4): 380-384
Article in English | IMSEAR | ID: sea-160058

ABSTRACT

This report describes 6 HIV-negative patients including 5 children with scrofuloderma and an adult with lupus vulgaris, out of a total of 303 cases of cutaneous tuberculosis seen during a 4½-year period, who showed a positive tuberculin test and granulomatous histopathology, but failed to respond to fi rst-line antitubercular therapy. They were suspected to have multidrug-resistant infection as no other cause could be ascertained. Tissue aspirate or biopsy was sent for histopathology and culture. Mycobacterium tuberculosis was isolated from the aspirate in three patients and sputum in one with associated pulmonary tuberculosis. Drug susceptibility tests showed that all isolates were resistant to rifampicin and isoniazid, and one each additionally to streptomycin and ethambutol, respectively. In two, culture was unsuccessful. All were administered second-line antitubercular drugs. Clinical improvement was appreciable within 2 months as weight gain, and regression of ulcers, swellings and plaques. Two completed the recommended 24 months of therapy. Multidrug-resistant cutaneous tuberculosis should be suspected in patients with no response to fi rst-line drugs, with clinical deterioration, and where other causes of treatment failure are not forthcoming. Owing to poor isolation rates on culture and low sensitivity of molecular tests, in such cases, a trial of second-line anti-tubercular drugs may be justifi ed for a reasonable period of 2 months. Where facilities permit, culture and drug sensitivity tests should be done before starting treatment. Culture positivity is better from aspirated material.


Subject(s)
Adolescent , Adult , Child , Drug Resistance, Multiple , Female , Humans , Male , Mycobacterium tuberculosis , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy , Tuberculosis, Cutaneous/epidemiology , Tuberculosis, Cutaneous/etiology , Tuberculosis, Cutaneous/pathology
15.
Rev. chil. dermatol ; 31(2): 155-160, 2015. ilus, tab
Article in Spanish | LILACS | ID: biblio-836006

ABSTRACT

La Tuberculosis Cutánea es una enfermedad infecciosa crónica causada por el Mycobacterium tuberculosis. Pese a ser una forma poco frecuente de presentación de la Tuberculosis, representa un gran desafío para los clínicos que se enfrentan a estos casos, debido principalmente a la gran diversidad de formas clínicas existentes. A continuación presentamos 2 casos clínicos de Tuberculosis Cutánea diagnosticados en el Hospital Regional de Talca y una revisión del tema basada en la clasificación, diagnóstico y tratamiento de la enfermedad.


Cutaneous Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. Despite being a rare presentation of the disease, Cutaneous Tuberculosis is a major challenge for clinicians who face these cases, mainly due to the great diversity of clinical forms. We present 2 cases of Cutaneous Tuberculosis diagnosed in Hospital Regional de Talca and a review of the topic based in classification, diagnosis and treatment of the disease.


Subject(s)
Humans , Male , Female , Middle Aged , Tuberculosis, Cutaneous/classification , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Erythema Induratum/classification , Erythema Induratum/diagnosis , Erythema Induratum/therapy
17.
Arch. argent. pediatr ; 112(3): e93-e96, jun. 2014. ilus
Article in Spanish | LILACS | ID: lil-708496

ABSTRACT

Se denomina tuberculosis cutánea a la enfermedad cutánea infecciosa crónica ocasionada por el Mycobacterium tuberculosis. Es poco frecuente y particularmente difícil de diagnosticar. Su incidencia, según la bibliografía, oscila entre el 1,5 y el 4% de todas las formas de tuberculosis extrapulmonares. Las formas clínicas dependen de la vía de llegada del bacilo a la piel, del estado inmunológico del paciente y del medio ambiente. Se presenta un caso de tuberculosis cutánea en un niño con lesiones dermatológicas crónicas, de evolución tórpida, sin respuesta a los tratamientos instituidos, la biopsia de piel mostró granulomas caseosos. El objetivo es describir un paciente con una presentación clínica infrecuente de esta enfermedad, destacar la importancia de su reconocimiento y tratamiento precoz, y evitar así la aparición de complicaciones y secuelas.


Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It is not very frequent and particularly difficult to diagnose. It incidence ranges between 1.5 and 4% of all extrapulmonary tuberculosis, according to bibliography. The clinic presentations depend on the arrival via of the bacillus to the skin, the patient's immune state and the environment. We show a cutaneous tuberculosis on a child with chronic dermatologic lesions, with torpid evolution, without response to treatments; the skinbiopsy showed caseous granulomas. The aim is to show a patient with an infrequent clinic presentation of this disease, to emphasize the importance of an early recognition and treatment, avoiding the appearance of complications and sequels.


Subject(s)
Child , Humans , Male , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/drug therapy
20.
Dermatol. peru ; 23(4): 212-218, oct.-dic. 2013. ilus, tab
Article in Spanish | LILACS, LIPECS | ID: lil-765221

ABSTRACT

La tuberculosis cutánea es una enfermedad infecciosa crónica causada por el Mycobacterium tuberculosis. Se presenta en una variedad de formas clínicas que dependen de la vía de llegada del bacilo a la piel y del estado inmunológico del paciente. La reacción en cadena de la polimerasa (RCP) ha permitido enrolar en el grupo de la tuberculosis cutánea a entidades antes reconocidas como tuberculides. Sin embargo, en muchos casos, la RCP no está disponible en países en desarrollo, en los cuales la incidencia considerable presenta a la tuberculosis como un problema de salud pública. Se presenta cuatro pacientes con formas clínicas distintas de tuberculosis cutánea (tuberculide papulonecrótica, escrofuloderma, tuberculosis verrucosa cutis y eritema indurado de Bazin), que reciben tratamiento antituberculoso de acuerdo al esquema nacional de tratamiento con evolución favorable.


Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. lt comes in a variety of clinical forms depending on the route of arrival of the bacillus to the skin and the immune status of the patient. The polymerase chain reaction (PCR) has allowed enrolling in group TB skin entities before recognized as tuberculids; however often not available in developing countries in which the considerable incidence that tuberculosis has, it becomes a problem public health. We report 4 patients with different clinical forms of cutaneous tuberculosis (tuberculid papulonecrotic, scrofuloderma, tuberculosis verrucosa cutis and indurated erythema Bazin) receiving tuberculosis treatment according to national treatment regimen with a favorable evolution.


Subject(s)
Humans , Male , Adult , Young Adult , Middle Aged , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/classification , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/etiology , Tuberculosis, Cutaneous/therapy
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