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Cutaneous tuberculosis: a
15-year descriptive study.
Enferm
Infecc Microbiol Clin. 2008;26(4):205-11.
INTRODUCTION: Cutaneous
tuberculosis has experienced a resurgence following a period of decline. The
aim of this study was to determine the clinical and epidemiological
characteristics of cutaneous tuberculosis in the Ferrol Healthcare Area
(Spain). METHODS: Between 1991-2005, 1139 new cases of tuberculosis were
diagnosed in Ferrol and submitted to a descriptive analysis. Cutaneous
involvement was investigated in all cases. RESULTS: Among 1139 patients, 55
cases of cutaneous tuberculosis were diagnosed (4.8%). The condition was
more frequent in women (70.9%), average age was 44.1 +/- 23.3 years, and
56.4% of patients were treated with 6HR2Z-E. Among the 55 cases, 26 (2.3%)
were true cutaneous tuberculosis and 29 (2.5%) were tuberculids. In the 26
cases of true tuberculosis, the most frequent form was scrofuloderma
(32.7%), followed of lupus vulgaris (7.2%), tuberculous gumma (3.6%), and
tuberculosis verrucosa cutis (3.6%). The most frequent locations were the
neck, face and trunk, and in 76.9% other sites were involved (lymph nodes
14, bone 6, lung 4, and intestine 1). In the 29 cases with tuberculids,
erythema nodosum was the most frequent form (49.1%) followed by erythema
induratum of Bazin (3.6%). The lower extremities were affected in all cases
and there was simultaneous involvement of other site in 51.9%. In patients
with true cutaneous tuberculosis, the diagnostic yield was greater
(necrotizing granulomas in 70.6% of biopsies and positive Löwenstein culture
for Mycobacterium tuberculosis in 77.8%) and average age was higher than in
patients with tuberculids (P < .05). CONCLUSION: Cutaneous tuberculosis is
uncommon, preferentially affects women, and is usually associated with
tuberculous disease in other locations, particularly in the case of
scrofuloderma. |