CUTANEOUS TUBERCULOSIS Cutaneous TB Relatively uncommon form of

CUTANEOUS TUBERCULOSIS

Cutaneous TB Relatively uncommon form of extra pulmonary tuberculosis Incidence is rising recently due to HIV pandemic Caused by M. tuberculosis or rarely by M. bovis Clinical feature depends on the host immunity and the route of infection and classified as primary or postprimary skin TB.

Tuberculous Chancre The result of the inoculation the bacilli into the skin of an individual without immunity. It enters the skin through abrasions and minor injuries. The early lesion is a nondescript, brownish papule or nodule, or a ragged ulcer with an undermined edge and a granular hemorrhagic base. In time, the edge becomes firmer, and a thin adherent crust develops.

Tuberculous Chancre Ulcerated and edematous mucosal lesions may also be seen. The chancre will heal slowly, taking many months, may proceed to lupus vulgaris or rarely to miliary TB

Tuberculosis Verrucosa Cutis An indolent, warty, plaque-like form occurring as a result of the inoculation of organisms into the skin of a previously infected patient. Starts as a small, symptomless, indurated, warty papule with a slight inflammatory areola. By gradual extension, a verrucose plaque is formed.

Tuberculosis Verrucosa Cutis Deeply destructive papillomatous and sclerotic forms may cause deformity of the limbs. The condition responds to antituberculosis treatment; without it, extension is usually extremely slow and lesions may remain virtually inactive for months or years

Tuberculosis Colliquativa Cutis (Scrofuloderma) Results from the involvement and breakdown of the skin overlying a contiguous tuberculosis focus. Numerous fistulae may intercommunicate beneath ridges of a bluish skin. Progression and scarring produce irregular adherent masses.

Lupus vulgaris A chronic progressive post-primary form of cutaneous tuberculosis occurring in a person with a moderate or high degree of immunity. It originates from underlying TB foci It can also arise after exogenous inoculation or as a complication of BCG vaccination.

Lupus vulgaris Most of the cases occur in the head and neck. Mucosa may be involved.

Tuberculous Gumma Metastatic tuberculous abscess. The result of haematogenous dissemination from a primary focus during periods of lowered resistance. Manifests as single or multiple subcutaneous nodule or fluctuant abscess.

Treatment v anti TB v debridement/drainage is CI

Buruli Ulcer Non tuberculous mycobacterial infection caused by M. ulcerans. Infection is acquired from contaminated soil. Starts as small painless intradermal nodule on the extremity that gradually extends to form irregular shalow necrotic ulcer that may reach several centimeters Constitutional symptoms are typically absent.