A clinicopathological study of cutaneous tuberculosis at Pune district, Maharashtra

This study was planned to assess the disease pattern of cutaneous tuberculosis in western India. Cutaneous tuberculosis forms one of the major chronic infective disorders of the skin. Interestingly, tuberculosis has re-emerged in areas with high prevalence of HIV infection. It is due to impaired cell-mediated immunity as a consequence of HIV infection results in the reactivation of persisters, the dormant strains of Mycobacterium tuberculosis. A total of 46 cases of clinically diagnosed patients of cutaneous tuberculosis attending dermatology out patient department and those admitted in the dermatology wards over a period of 2 years were included in the study. A detailed clinical examination and investigations including histopathological examination were carried out. Lupus vulgaris was the most common form seen in 39.14% cases followed by Scrofuloderma in 30.43%, tuberculosis verrucosa cutis in 20.74%. The Mantoux test was positive in all cases. In 91% cases a granuloma composed of epitheloid cells, giant cells, lymphocytes were seen. In most (64.28%) cases of scrofuloderma, granuloma was occupying lower and mid-dermis. Granulomas were in mid and upper dermis in majority (85.71%) cases of tuberculosis verrucosa cutis and were in upper dermis in (52.94%) cases of lupus vulgaris. The diagnosis of skin tuberculosis should be based on basis of history and evolution of the disease, cardinal clinical features, response to Mantoux test and histopathologic characteristics.