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Mann D, Sant'Anna FM, Schmaltz CAS, Rolla V, Freitas DFS, Lyra MR, Sampaio FMS, do Valle ACF, Lourenço MCS, Quintella LP, Teichner TC, Cavalcante SC, Galhardo MCG. Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases. Int J Dermatol 2019; 58:1451-1459. [PMID: 31553059 DOI: 10.1111/ijd.14617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/12/2019] [Accepted: 08/08/2019] [Indexed: 12/31/2022]
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.
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Affiliation(s)
- Danielle Mann
- Post Graduation of Clinical Research on Infectious Diseases, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Flavia M Sant'Anna
- Laboratory of Clinical Research in Mycobacteriosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Carolina A S Schmaltz
- Laboratory of Clinical Research in Mycobacteriosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Valeria Rolla
- Laboratory of Clinical Research in Mycobacteriosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Dayvison F S Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo R Lyra
- Laboratory of Clinical Research in Leishmaniasis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Felipe M S Sampaio
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Antonio C F do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maria C S Lourenço
- Laboratory of Bacteriology and Bioassays, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Leonardo P Quintella
- Anatomical Pathology Service, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Tullia C Teichner
- Anatomical Pathology Service, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Solange C Cavalcante
- Laboratory of Clinical Research in Mycobacteriosis, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maria C G Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Chaabouni R, Bahloul E, Boudaya S, Frikha F, Amouri M, Turki H. [A rash of the face]. Rev Med Interne 2019; 40:696-697. [PMID: 30857824 DOI: 10.1016/j.revmed.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/10/2019] [Indexed: 11/17/2022]
Affiliation(s)
- R Chaabouni
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie.
| | - E Bahloul
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - S Boudaya
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - F Frikha
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - M Amouri
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
| | - H Turki
- Service de dermatologie, centre hospitalo-universitaire Hédi-Chaker, 3029 Sfax, Tunisie
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Diop A, Ndiaye MT, Ndiaye M, Seck B, Diouf A, Diatta BH, Diallo M, Ly F. Rare cutaneous tuberculosis in Sub-Saharan Africa developed on discoid lupus erythematous lesion. ACTA ACUST UNITED AC 2017; 110:230-233. [PMID: 28247256 DOI: 10.1007/s13149-017-0550-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 11/22/2016] [Indexed: 11/28/2022]
Abstract
Lupus vulgaris is a common presentation of cutaneous tuberculosis (TB), but its ulcerative or vegetating form also called vorax is rare.We report a case of lupus vulgaris in its vorax form, which occurred in a patient with discoid lupus erythematous. A 42-year-old patient monitored for chronic lupus erythematosus consulted again for a facial tumor and fever. Physical examination revealed painful ulcerative and crusted lesions on an old discoid lupus lesion and covered the entire upper lip. Similar lesions were noted on cheeks. Moreover, there were cervical lymphadenopathy, a bilateral pulmonary condensation syndrome, and dysphonia. Cutaneous histopathology had revealed a tuberculoid granuloma without caseating, and nucleic acid amplification tests (GeneXpert®) performed on sputum were positive. Thus, the diagnosis of multifocal TB with skin involvement of vorax type was confirmed. The outcome was favorable following TB treatment. Our observation is distinctive as it is a granulomatosis and ulcerative form of lupus vulgaris, which occurred on a discoid lupus erythematous lesion. This is a rare form of lupus vulgaris. This scarcity can be explained by diagnostic difficulties as there are numerous differential diagnoses and histopathology is not often helpful.
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Affiliation(s)
- A Diop
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal.
| | - M T Ndiaye
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal
| | - M Ndiaye
- Dermatologie, hôpital Aristide-Le-Dantec Dakar, université Cheikh-Anta-Diop de Dakar, Dakar, Sénégal
| | - B Seck
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal
| | - A Diouf
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal
| | - B H Diatta
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal
| | - M Diallo
- Dermatologie, hôpital Aristide-Le-Dantec Dakar, université Cheikh-Anta-Diop de Dakar, Dakar, Sénégal
| | - F Ly
- Dermatologie, hôpital institut d'hygiène sociale de Dakar, université Cheikh-Anta-Diop de Dakar, BP 7045, Dakar, Sénégal
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Sellami K, Boudaya S, Chaabane H, Amouri M, Masmoudi A, Mseddi M, Turki H. Twenty-nine cases of lupus vulgaris. Med Mal Infect 2016; 46:93-5. [DOI: 10.1016/j.medmal.2015.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 09/13/2015] [Accepted: 12/17/2015] [Indexed: 11/27/2022]
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Amouri M, Ben Salah R, Chaaben H, Meziou TJ, Mseddi M, Turki H. Lupus tuberculeux d’évolution prolongée. Ann Dermatol Venereol 2011; 138:637-8. [DOI: 10.1016/j.annder.2011.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 05/03/2011] [Accepted: 05/11/2011] [Indexed: 10/18/2022]
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