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Cutaneous tuberculosis: A great imitator.
Clin Dermatol. 2019 May - Jun; 37(3):192-199.CD

Abstract

Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.

Authors+Show Affiliations

Department of Dermatology, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China.Department of Dermatology and Allergy, Technische Universität München, Munich, Germany. Electronic address: wenchieh65.chen@gmail.com.Department of Dermatology, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31178102

Citation

Chen, Qiquan, et al. "Cutaneous Tuberculosis: a Great Imitator." Clinics in Dermatology, vol. 37, no. 3, 2019, pp. 192-199.
Chen Q, Chen W, Hao F. Cutaneous tuberculosis: A great imitator. Clin Dermatol. 2019;37(3):192-199.
Chen, Q., Chen, W., & Hao, F. (2019). Cutaneous tuberculosis: A great imitator. Clinics in Dermatology, 37(3), 192-199. https://doi.org/10.1016/j.clindermatol.2019.01.008
Chen Q, Chen W, Hao F. Cutaneous Tuberculosis: a Great Imitator. Clin Dermatol. 2019 May - Jun;37(3):192-199. PubMed PMID: 31178102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cutaneous tuberculosis: A great imitator. AU - Chen,Qiquan, AU - Chen,WenChieh, AU - Hao,Fei, Y1 - 2019/01/11/ PY - 2019/6/11/entrez PY - 2019/6/11/pubmed PY - 2019/6/11/medline SP - 192 EP - 199 JF - Clinics in dermatology JO - Clin. Dermatol. VL - 37 IS - 3 N2 - Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted. SN - 1879-1131 UR - https://www.unboundmedicine.com/medline/citation/31178102/Cutaneous_tuberculosis:_A_great_imitator L2 - https://linkinghub.elsevier.com/retrieve/pii/S0738-081X(19)30008-2 DB - PRIME DP - Unbound Medicine ER -