Skin Lesions Associated with Tuberculosis

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Skin Lesions Associated with Tuberculos

Skin Lesions Associated with Tuberculosis

  • Lupus vulgaris: Most common form of cutaneous TB in immunocompetent individuals; presents as reddish-brown plaques with "apple-jelly" nodules on diascopy.
  • Scrofuloderma: Results from direct extension of TB infection from underlying lymph nodes, bones, or joints; appears as painless subcutaneous nodules that ulcerate and form sinus tracts.
  • Tuberculosis verrucosa cutis (TVC): Warty, hyperkeratotic plaques typically on hands or feet; occurs after exogenous inoculation in previously sensitized individuals.
  • Miliary tuberculosis with skin involvement: Rare; seen in disseminated TB, especially in immunocompromised patients; presents as papules, pustules, or nodules.
  • Tuberculid reactions (e.g., papulonecrotic tuberculid, erythema induratum/Bazin disease): Immune-mediated hypersensitivity reactions to TB antigens; not true cutaneous TB (no detectable mycobacteria).

FAQ

Are all skin lesions in TB caused by direct infection?

No. Only lupus vulgaris, scrofuloderma, and TVC result from direct mycobacterial invasion. Tuberculids are hypersensitivity reactions without viable organisms in the skin.

How is cutaneous TB diagnosed?

Diagnosis involves skin biopsy (histopathology), tuberculin skin test or IGRA, PCR for Mycobacterium tuberculosis, and culture. Clinical context (e.g., prior TB exposure) is crucial.

References

  • James, W. D., et al. Andrews' Diseases of the Skin, 13th ed.
  • World Health Organization (WHO). Guidelines for TB diagnosis and management.
  • Sinha, A. A., & Khunger, N. (2019). Cutaneous tuberculosis revisited. Indian Journal of Dermatology.

Hashtags

#CutaneousTB #Tuberculosis #Dermatology #LupusVulgaris #TBdiagnosis

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