Cutaneous tuberculosis: a rare presentation in an immigrant

Climate change, human migration, and skin disease: is there a link?

Climate change, exemplified by higher average global temperatures resulting in more frequent extreme weather events, has the potential to significantly impact human migration patterns and health. The consequences of environmental catastrophes further destabilize regions with pre-existing states of conflict due to social, political, and/or economic unrest. Migrants may carry diseases from their place of origin to their destinations and once there may be susceptible to diseases in which they had not been previously exposed to. Skin diseases are among the most commonly observed health conditions observed in migrant populations. To improve awareness among dermatologists of the burden of skin diseases among migrants, the group searched the English language scientific literature to identify articles linking climate change, migration, and skin disease. Skin diseases associated with human migration fall into three major categories: (i) communicable diseases, (ii) noncommunicable diseases, and (iii) environmentally mediated diseases. Adopting comprehensive global strategies to improve the health of migrants requires urgent attention.

Clinical spectrum of cutaneous tuberculosis in Central India: A retrospective study

Introduction:

Extrapulmonary tuberculosis (EPTB) is a significant health problem in both developing and developed countries. In India, cutaneous TB constitutes about 0.1% to 2% of the total skin diseases attending outpatients.

Aim and objectives:

To study the clinical spectrum and therapeutic outcome in cutaneous TB.

Material and Methods:

Medical records of diagnosed cases of cutaneous TB from June 2015 to June 2018 were analyzed retrospectively with respect to epidemiology, clinical features, investigations, and treatment outcome. Statistical analysis was done using mean, median, and proportion.

Results:

Fifty-two patients with cutaneous TB were recruited. Females (61.53%) outnumbered males. The most common age group affected was 21–30 years (32.69%) followed by 41–50 years (30%). Lupus vulgaris was the most common clinical type with head and neck being the most common site of involvement. Mantoux positivity was reported in 67.30% of patients while raised ESR in 71.15% of patients. Two patients had serology positive for HIV. Conclusive evidence of TB on histopathology was reported in 86.53%. Excellent response was observed in cases of lupus vulgaris, scrofuloderma, and tuberculosis verrucosa cutis.

Conclusion:

This retrospective analysis emphasizes the importance of clinicopathological correlation and therapeutic response in cutaneous TB. Although positive results of ESR, Mantoux reactivity, and TB cultures facilitate the clinical diagnosis, negative results should not exclude the diagnosis of cutaneous TB. This prominent case detection in the era of the Revised National TB Control Programme, in short period of time signifies health burden of cutaneous TB in this part of Maharashtra.

Rare Case of Pulmonary Tuberculosis with Hematogenous Spread to Larynx and Skin

ABSTRACT: Introduction: Tuberculosis is an infectious disease with various clinical and radiological symptoms which are determined primarily by the immune system of the host towards the infection with Mycobacterium tuberculosis. The infection with M. tuberculosis can be limited to an organ or it can spread through hematogenous or lymphatic route to other organs (especially cases of younger or older people). Tuberculosis always needs bacteriological or histopathological confirmation. Matherial and method: We present the case of a 62 year old woman investigated and treated in our Hospital in 2009-2010 for Pulmonary tuberculosis complicated with Laryngeal Tuberculosis and Skin Tuberculosis (confirmed by histopathological exams). We intend to focus our case report on the cutaneous form of tuberculosis because of its rareness and clinical interest. Conclusions: Cutaneous tuberculosis is a very rare form of extrapulmonary tuberculosis and can be highly variable in its clinical appearance, significance and prognosis. Lesions of the skin are a real challenge for dermatologists. The treatment of cutaneous tuberculosis in most cases is the same as for pulmonary tuberculosis leading to regression and healing of the skin lesions.

Lupus vulgaris developing at the site of misdiagnosed scrofuloderma

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis primarily occurring in developing countries. The recent increase in the incidence of tuberculosis, especially due to human immunodeficiency virus (HIV) infections, has led to a resurgence of extrapulmonary forms of this disease. We describe a case of lupus vulgaris in a 33-year-old woman who had a 5-year history of a slowly growing plaque on her neck. The lesion was located at the site of surgery repairing the scar resulting from the incision of a subcutaneous abscess during childhood. This lesion was misdiagnosed as bacterial abscess. Histopathologic examination of the plaque revealed non-caseating tuberculoid granulomas consisting of lymphocytes, epithelioid and giant cells. Staining for acid-fast bacilli and culture from biopsied tissue was negative. Polymerase chain reaction (PCR) for detection of Mycobacterium tuberculosis DNA, performed on a skin biopsy specimen, was positive. A diagnosis of lupus vulgaris developing at the site of a previous misdiagnosed scrofuloderma was made. Conventional antitubercular therapy with rifampicin, isoniazid and ethambutol was administered for 6 months, resulting in resolution of the lesion.

Antibacterial activity of ozonized sunflower oil (Oleozon)

AIMS

To evaluate the antimicrobial effect of the ozonized sunflower oil (Oleozon) on different bacterial species isolated from different sites.

METHODS AND RESULTS

The effect of Oleozon on Mycobacteria, staphylococci, streptococci, enterococci, Pseudomonas and Escherichia coli was tested. The sunflower oil was ozonized at the Centro de Investigaciones del Ozone (CENIC, Havana, Cuba) by an ozone generator. MICs were determined by the agar dilution method. For Mycobacteria, the MIC of Oleozon was determined on solid medium by a microdrop agar proportion test. Oleozon showed antimicrobial activity against all strains analysed, with an MIC ranging from 1.18 to 9.5 mg ml-1.

CONCLUSION

Oleozon showed a valuable antimicrobial activity against all micro-organisms tested. Results suggest that Mycobacteria are more susceptible to Oleozon than the other bacteria tested.

SIGNIFICANCE AND IMPACT OF THE STUDY

The wide availability of sunflower oil makes Oleozon a competitive antimicrobial agent. These results should prompt the setting up of some clinical trials to compare Oleozon with other antimicrobial agents.

Imported tropical respiratory tract infections

As the trends in travel continue to rise, travelers are exposed increasingly to a variety of infectious diseases, either by virtue of their chosen geographic destination or as a result of underlying immunosuppressive disease. Little has been published regarding imported tropical respiratory diseases. This article, however, reviews the incidence of respiratory disease both by destination and by travel-related risk groups and factors.