Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

Int J Dermatol. 2019 Dec;58(12):1451-1459. doi: 10.1111/ijd.14617. Epub 2019 Sep 25.

Abstract

Background: Brazil is one of the highest tuberculosis (TB) burden countries of the world. Cutaneous tuberculosis (CTB) is a rare form of extrapulmonary manifestation of tuberculosis. This study aimed to describe the clinico-evolutive, laboratory and therapeutic aspects of CTB cases among patients from a cohort with TB in Rio de Janeiro, Brazil.

Methods: Cases of diagnosed CTB with microbiologic confirmation or clinical response to anti-tuberculous treatment associated with positive smear or histopathological findings between the years 2000 and 2016 were selected.

Results: Seventy-five patients with CTB were included, most were women (58.7%) with a median age of 42 years. CTB diagnosis was based on culture in only 42.7% of the cases. Scrofuloderma represented 50.7% of the cases, followed by erythema induratum of Bazin (EIB) (18.7%), tuberculous gumma (13.3%), lupus vulgaris (8%), TB verrucosa cutis (4%), orificial TB (2.7%) and associated forms (2.7%). Other TB presentations were pulmonary (22.7%), mammary (6.6%) and osteoarticular (4%). All patients who completed the treatment (97.3%) had their lesions healed. Only two patients (2.6%) needed to change the therapy due to adverse reactions. Fifty percent of EIB patients presented recurrence.

Conclusions: These data highlight the diversity of CTB presentations and the importance of the skin to assist in early identification and treatment of TB. More studies are necessary to improve the knowledge on EIB for a better approach towards these patients, mainly in cases of recurrence.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use*
  • Brazil / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Prospective Studies
  • Skin / microbiology
  • Skin / pathology
  • Treatment Outcome
  • Tuberculosis, Cutaneous / drug therapy
  • Tuberculosis, Cutaneous / epidemiology*
  • Tuberculosis, Cutaneous / microbiology
  • Tuberculosis, Cutaneous / pathology
  • Tuberculosis, Osteoarticular / drug therapy
  • Tuberculosis, Osteoarticular / epidemiology*
  • Tuberculosis, Osteoarticular / microbiology
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult

Substances

  • Antitubercular Agents