Cutaneous Tuberculosis (Scrofuloderma)

Diagnosis: Cutaneous Tuberculosis (Scrofuloderma)

Granulation tissue at sites of draining sinuses, and a still active nodule.

Clinical Presentation

Granulation tissue at sites of draining sinuses, and a still active nodule.

Clinical History

Submitted by Alaa Saad. Originally posted September 22, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Sporotrichosis • Sarcoidosis • Leprosy • Deep fungal infection • Leishmaniasis • Squamous cell carcinoma • Lupus vulgaris (another form of cutaneous TB)

Key Learnings

• Cutaneous TB: <2% of all TB cases • Lupus vulgaris: most common form of cutaneous TB — "apple-jelly" nodules on diascopy • Scrofuloderma: TB extension from underlying lymph node or bone — draining sinuses • Tuberculosis verrucosa cutis: inoculation TB in previously sensitized individual • Diagnosis: biopsy (caseating granulomas), culture, PCR, QuantiFERON/PPD • Standard anti-TB therapy (RIPE regimen) for all forms

Tags: cutaneous, tuberculosis, scrofuloderma, alaa saad