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Picture of the Month—Diagnosis
Arch Pediatr Adolesc Med. 2007;161(12):1212.
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Denouement and Discussion: Scrofuloderma With Lupus Vulgaris
The result of tuberculin skin testing was positive, with a 20 x 25-mm induration associated with vesiculation. The sputum examination result for acid-fast bacilli was negative. Pus aspirated from the cold abscess, and a smear from the ulcers did not reveal any mycobacteria on Ziehl-Neelsen acid-fast stain; however, a biopsy specimen from the skin lesion and sinuses revealed tuberculous granulomatous infection. Routine culture eventually grew Mycobacterium tuberculosis, and the patient was diagnosed as having scrofuloderma (SCD) and lupus vulgaris (cutaneous tuberculosis). He responded well to drainage of cold abscesses and standard antituberculous drug therapy, composed of isoniazid, rifampicin sodium, pyrazinamide, and ethambutol hydrochloride.
The incidence of cutaneous tuberculosis, which forms a minute proportion of extrapulmonary tuberculosis, has decreased from 2% to 0.15% in India.1 In the West, it is rarely encountered. Lupus vulgaris, SCD, tuberculosis verrucosa cutis, tuberculous gumma, tuberculids, tubercular chancre, acute miliary cutaneous tuberculosis, and orificial tuberculosis . . . [Full Text of this Article]
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Picture of the Month—Quiz Case
Dipesh D. Duttaroy, Jitendra Jagtap, Ujjwal Bansal, and Bithika Duttaroy
Arch Pediatr Adolesc Med. 2007;161(12):1211.
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