Subject(s)
Acrodermatitis , COVID-19 , Humans , Acrodermatitis/diagnosis , Acrodermatitis/etiology , COVID-19/complicationsSubject(s)
COVID-19 , Chilblains , Chilblains/epidemiology , Disease Outbreaks , Humans , Pandemics , SARS-CoV-2Subject(s)
Coronavirus Infections/epidemiology , Infection Control/organization & administration , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Skin Diseases/diagnosis , Telemedicine , COVID-19 , Cohort Studies , Coronavirus Infections/prevention & control , Dermatology/methods , Female , Humans , Male , Outcome Assessment, Health Care , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Referral and Consultation/statistics & numerical data , Retrospective StudiesABSTRACT
Cutaneous tuberculosis with lymphatic spread is rarely described. We report the case of a woman aged 38, immunocompetent, working in a fruit sorting center, who consulted us for ulceration of the left third finger that had persisted for four months, following a prick from a prickly pear. Physical examination revealed a nodular, erythematous, and ulcerative lesion of the left third finger, associated with inflammatory subcutaneous nodules arranged in a line along the ipsilateral upper extremity and an ipsilateral axillary lymph node. Laboratory tests and chest X-ray were normal. Pathological examination revealed granulomatous chronic inflammation without necrosis. PCR detected DNA from Mycobacterium tuberculosis. No extracutaneous tuberculosis locations were detected. A tuberculous chancre by direct inoculation was therefore diagnosed. The patient received quadruple therapy (rifampicin + isoniazid + pyrazinamide + ethambutol) for 2 months, followed by a combination therapy based on isoniazid and rifampicin for 6 months. Marked regression of the cutaneous lesions occurred after 1 month of first-line therapy. A tuberculous chancre is a rare form of cutaneous tuberculosis, with possible lymphatic spread, in immunocompromised patients but also in immunocompetent children and young adults.