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    Clinical Presentations of Cutaneous Tuberculosis: Original Article

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    Silma Farraha
    This study examined 57 cases of histologically-confirmed cutaneous tuberculosis seen over three years at hospitals in Karachi, Pakistan. The most common presentation was scrofuloderma, seen in 35 patients (62%), followed by lupus vulgaris and tuberculosis verrucosa cutis. Most patients were between 11-30 years old and had lesions on the limbs. Chronic discharging sinuses and plaques were the most typical lesions. Scrofuloderma was more common in females while some types were more frequent in males.

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    Clinical Presentations of Cutaneous Tuberculosis: Original Article

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    Silma Farraha
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    This study examined 57 cases of histologically-confirmed cutaneous tuberculosis seen over three years at hospitals in Karachi, Pakistan. The most common presentation was scrofuloderma, seen in 35 patients (62%), followed by lupus vulgaris and tuberculosis verrucosa cutis. Most patients were between 11-30 years old and had lesions on the limbs. Chronic discharging sinuses and plaques were the most typical lesions. Scrofuloderma was more common in females while some types were more frequent in males.

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    This study examined 57 cases of histologically-confirmed cutaneous tuberculosis seen over three years at hospitals in Karachi, Pakistan. The most common presentation was scrofuloderma, seen in 35 patients (62%), followed by lupus vulgaris and tuberculosis verrucosa cutis. Most patients were between 11-30 years old and had lesions on the limbs. Chronic discharging sinuses and plaques were the most typical lesions. Scrofuloderma was more common in females while some types were more frequent in males.

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    33 views3 pages

    Clinical Presentations of Cutaneous Tuberculosis: Original Article

    Uploaded by

    Silma Farraha
    This study examined 57 cases of histologically-confirmed cutaneous tuberculosis seen over three years at hospitals in Karachi, Pakistan. The most common presentation was scrofuloderma, seen in 35 patients (62%), followed by lupus vulgaris and tuberculosis verrucosa cutis. Most patients were between 11-30 years old and had lesions on the limbs. Chronic discharging sinuses and plaques were the most typical lesions. Scrofuloderma was more common in females while some types were more frequent in males.

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    Journal of Pakistan Association of Dermatologists 2014;24 (2):132-137.

    Original Article
    Clinical presentations of cutaneous tuberculosis
    Najam-us Saher*, Zarnaz Wahid*, Ijaz Ahmed**, Sadaf Ahmed Asim*, Farzana Riaz

    * Department of Dermatology, Civil Hospital Karachi and Dow University of health Sciences,
    Karachi
    ** Department of Dermatology, Ziauddin University, Karachi

    Abstract Objective To determine the frequency of different clinical presentations of cutaneous tuberculosis in
    a tertiary care hospital.

    Methods This cross-sectional study was carried out in the Department of Dermatology, Civil
    Hospital, Karachi and Department of Dermatology, Ziauddin University, Karachi, over three years
    th th
    from 5 March 2007 to 4 March 2010. Patients of both sexes and all age groups suffering from
    histologically-confirmed cutaneous tuberculosis for last 1 month to 10 years were enrolled. A
    detailed history and examination were recorded on a predesigned proforma. The collected data were
    computed and analyzed.

    Results 57 diagnosed (biopsy proven) cases of cutaneous tuberculosis comprising 35 females


    (61.4%) and 22 males (38.6%) were enrolled. The age range was 1 up to 80 years. Among these
    subjects, half the patients were aged between 11-30 years. 17 patients (29.8%) had the disease for 1-
    2 years constituting the highest frequency for the duration of illness. Most of the patients i.e. 33
    (57.5%) had more than one lesion. The lesions were most commonly seen on limbs in 25 (43.4%)
    patients, followed by face and neck, trunk and genitalia. Chronic discharging sinuses and plaques
    were the most common presentations. Scrofuloderma was the most common tuberculosis cutis seen
    in 35 (62%) patients followed by lupus vulgaris, warty tuberculosis and tuberculids. Overall
    frequency was higher in females. However, some of the types were more frequent in females while
    others in males. Mean age of presentation for scrofuloderma was 25.716.9 years, warty
    tuberculosis 25.715.9 years, lupus vulgaris 29.416.5 years and tuberculids 3011.9 years
    (p=0.197).

    Conclusion Scrofuloderma is the most common clinical presentation of tuberculosis cutis seen in
    our setting followed by lupus vulgaris, tuberculosis verrucosa cutis and tuberculids.

    Key words
    Cutaneous tuberculosis, scrofuloderma, lupus vulgaris, tuberculosis verrucosa cutis, tuberculids.

    Introduction pulmonary tuberculosis and multidrug


    2,3
    resistance. Cutaneous tuberculosis has a
    More than 2 billion people (about one-third of worldwide distribution with malnourishment and
    the world population) are estimated to be low socioeconomic status being the main
    infected with Mycobacterium tuberculosis.1 predispositions.
    Cutaneous tuberculosis has re-emerged in the
    last 15 years together with a higher incidence of M. tuberculosis can induce a spectrum of
    cutaneous changes depending on the route of
    Address for correspondence infection and immunological status of the host.
    Prof. Ijaz Ahmad
    Professor of Dermatology Primary infection of skin produces tuberculous
    Department of Dermatology, Ziauddin chancre in a non-immune host, while
    University, Karachi. tuberculosis verrucosa cutis occurs as a primary
    Email: ijaza_az@hotmail.com

    132
    Journal of Pakistan Association of Dermatologists 2014;24 (2):132-137.

    infection in an immunologically competent host. Methods


    Post-primary skin lesion e.g. lupus vulgaris, is a
    common presentation of cutaneous tuberculosis. Current, descriptive, cross-sectional study was
    Scrofuloderma results from contiguous carried out in the Department of Dermatology,
    involvement of skin overlying a tuberculous Civil Hospital, Karachi and Department of
    focus e.g. lymph nodes, bones, joints or testicles. Dermatology, Ziauddin University, Karachi. The
    Hematogenous spread can lead to miliary study was completed over a period of three
    th
    tuberculosis. Orificial, perioral or perianal years, spanning from 5 March, 2007 till 4th
    tuberculosis can occur following ingested March, 2010.
    mycobacteria. Tuberculids once attributed to
    cutaneous immunological reactions to Patients were selected by non-probability
    tuberculosis elsewhere in the body in an immune purposive sampling. After an informed consent,
    host are now known to be true forms of patients of both sexes and all age groups
    cutaneous tuberculosis.4 suffering from the disease for 1 month to 10
    years were enrolled for the study. All the
    Early diagnosis and treatment yields better patients were histologically proven cases of
    outcome for the disease and if left untreated or cutaneous tuberculosis. Patients having any
    misdiagnosed it can lead to complications like other concomitant dermatological or systemic
    squamous cell or basal cell carcinoma especially problems were ruled out.
    in lupus vulgaris (8%).5
    After a detailed history and examination, the
    The incidence of different forms of cutaneous findings were recorded on a predesigned
    tuberculosis varies globally. Scrofuloderma has proforma. The clinical diagnosis was confirmed
    been reported to be the commonest form from by biopsy and histopathology. Any relevant
    UK6 and lupus vulgaris from South Africa. 7 In investigations were performed wherever
    India, scrofuloderma had the highest frequency required. These included complete blood count,
    in children while lupus vulgaris in adults. 8,9 In biochemical profile and urinalysis.
    Pakistan, scrofuloderma has been reported to be
    the most common form (64.9%). 10 Studies The data were compiled, tabulated and analyzed
    carried out in our country reveal a limited data with the help of SPSS Program version 10.0.
    regarding the frequency of different clinical Frequency and percentages were calculated for
    presentations of tuberculosis cutis.10 categorical data like gender and clinical type of
    cutaneous tuberculosis. Meanstandard
    The current study was targeted to determine the deviation was calculated for numerical variables
    frequency of different clinical presentations of like age. Frequency of clinical type of cutaneous
    cutaneous tuberculosis in our part of the world. tuberculosis was also presented according to
    The study will be helpful towards planning more gender, duration of illness and age in order to
    strategies for awareness about tuberculosis cutis control effect modifiers.
    for health care providers leading to early
    diagnosis and preventing lethal complications. Results

    A total of 57 diagnosed (biopsy proven) patients


    of cutaneous tuberculosis were enrolled

    133
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