Nuevo espectro de tuberculide papulosa: aspectos clínicos e histopatológicos a propósito de un caso / New spectrum of papular tuberculid: clinical and pathological aspects due to a case

Presentamos el caso de un paciente varón de 59 años de edad quien inicialmente presentó un cuadro clínico de tuberculide papulosa en rostro o tuberculide rosaceiforme, que progresivamente se extiende a cuero cabelludo, cuello, tronco y miembros superiores. Se plantea la posibilidad de que este nuevo espectro de tuberculides constituiría formas de tuberculosis cutánea paucibacilar.

We present the case of a 59-years-old male patient who was diagnosed of papular tuberculid or rosaceiform tuberculid in face, with progressive extension to the scalp, neck, trunk and arms. We propose that this new spectrum of tuberculids could be a paucibacilar form of cutaneous tuberculosis.

A Case of Papular Tuberculid and BCGitis after BCG Vaccination / 대한피부과학회지

BCG (Bacillus Calmette-Guerin), which produces resistance to tuberculosis infection, is a vaccine containing live, attenuated Mycobacterium bovis. It induces specific and nonspecific dermatologic complications. The specific reactions include scrofuloderma-like, lupus vulgaris-like, lichen nitidus-like, lymphadenitis and tuberculid. We report a case of papular tuberculid, which was presented as 3-5mm sized erythematous papules on the extremities and face, and BCGitis had developed around the vaccination site after BCG vaccination. Histopathologic examination of the papule and lymph node showed granuloma, consisting of epithelioid cells and lymphocytes.

Papular Tuberculid and Suppurative Lymphadenitis After BDG Vaccination / 대한피부과학회지

Various dermatological complications have been reported following the BCG vaccination although this vaccination has been recommended to all healthy infants in our country. A 4-months-old boy, who had a BCG vaccination three weeks after birth, developed erythematous papules and pustules on the whole body, especially on the face and upper extremities. Two erythematous subcutaneous soft nodules were also noted on the left side of the neck. A biopsy specimen from the right forearm revealed caseous necrosis surrounded by a granulomatous inflammation consisting of epithelioid cells and lymphocytes. It was centered along the axis of the damaged pilosebaceous follicle. No acid-fast bacilli could be demonstrated by AFB stain. A marked improvement of his skin eruptions was observed after anti-tuberculosis medication. However, nod-ules in the cervical area perforated spontaneously and healed leaving scars several months after the cutaneous eruptions subsided. The clinical and histologic findings and a good response to anti-tuberculous therapy support the diagnosis of papular tuberculid and suppurative lymphadenitis after BCG vaccination.