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Xu M, Fang F, Hamal K, Tang S, Liu D. Tuberculous Ulcerative Skin Lesion of the Penis: A Case Report. Infect Drug Resist 2024; 17:2817-2822. [PMID: 39005852 PMCID: PMC11245573 DOI: 10.2147/idr.s472573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
Genitourinary tuberculosis (GUTB), especially penile tuberculosis (PTB), is a disease often overlooked by urological specialists, especially in Europe, where the pathology is less frequent. In this report, we described a case of penile tuberculosis (PTB) characterized by ulcers on the penis. After the patient was administered three months of anti-tuberculosis treatment (isoniazid 0.3 g/qd, rifampicin 0.6 g/qw, and ethambutol 0.75 g/qd), the ulcer disappeared. The patient was followed up for seven months and showed no recurrence.
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Affiliation(s)
- Meilan Xu
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Fuxiang Fang
- Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Krishna Hamal
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Shenhou Tang
- The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, 545001, People’s Republic of China
| | - Donghua Liu
- Department of Dermatology and Venereology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
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2
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Kaul S, Jakhar D, Mehta S, Singal A. Cutaneous tuberculosis. Part II: Complications, diagnostic workup, histopathologic features, and treatment. J Am Acad Dermatol 2023; 89:1107-1119. [PMID: 35149148 DOI: 10.1016/j.jaad.2021.12.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/12/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
Abstract
Despite the availability of effective treatment regimens for cutaneous tuberculosis, challenges to disease control result from delayed diagnosis, infection with multidrug-resistant mycobacterial strains, and coinfection with HIV. Delayed diagnosis can be mitigated when dermatologists are sensitized to the clinical signs and symptoms of infection and by the incorporation of appropriate diagnostic tests. All cases of cutaneous tuberculosis should be confirmed with histopathology and culture with or without molecular testing. In each case, a thorough evaluation for systemic involvement is necessary. Mycobacteria may not be isolated from cutaneous tuberculosis lesions and therefore, a trial of antituberculosis treatment may be required to confirm the diagnosis. The second article in this 2-part continuing medical education series describes the sequelae, histopathology, and treatment of tuberculosis.
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Affiliation(s)
- Subuhi Kaul
- Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois
| | | | - Shilpa Mehta
- Division of Dermatology, John H Stroger Hospital of Cook County, Chicago, Illinois.
| | - Archana Singal
- Department of Dermatology, University College of Medical Sciences & GTB Hospital, Delhi, India
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3
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Nguyen KH, Alcantara CA, Glassman I, May N, Mundra A, Mukundan A, Urness B, Yoon S, Sakaki R, Dayal S, Chowdhury T, Harshavardhan S, Ramanathan V, Venketaraman V. Cutaneous Manifestations of Mycobacterium tuberculosis: A Literature Review. Pathogens 2023; 12:920. [PMID: 37513768 PMCID: PMC10385667 DOI: 10.3390/pathogens12070920] [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: 05/29/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Tuberculosis is an ancient disease that humanity struggled with for centuries and continues to struggle with. The bacteria Mycobacterium tuberculosis often infects the lungs through respiratory transmission and manifests itself through various symptoms, including cutaneous infections. Cutaneous tuberculosis (CTB) comprises about 1% to 1.5% of all extrapulmonary manifestations and is often accompanied by polymorphous lesions, including papules, nodules, plaques, ulcers, gummas, and verrucous lesions. CTB is most commonly observed in low-income, HIV, and immunosuppressed populations, similar to intrapulmonary manifestations. The main pathogen for CTB is M. tuberculosis but less commonly with M. bovis and BCG vaccine, and the modes of transmission are largely classified into exogenous and endogenous CTB. Current treatment options for CTB include oral therapy of antibiotic medications such as rifampicin, streptomycin, ethambutol, isoniazid, and pyrazinamide, which is occasionally combined with surgical intervention.
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Affiliation(s)
- Kevin H Nguyen
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Cheldon Ann Alcantara
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Ira Glassman
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Nicole May
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Akaash Mundra
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Abinanda Mukundan
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Bianca Urness
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Sonyeol Yoon
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Roajhaan Sakaki
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Surbi Dayal
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Tanzila Chowdhury
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Shakila Harshavardhan
- Department of Molecular Microbiology, Madurai Kamaraj University, Tamil Nadu 625021, India
| | - Vadakupattu Ramanathan
- Department of Pathology, National Institute for Research in Tuberculosis, Chennai 600031, India
| | - Vishwanath Venketaraman
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA
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4
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Zdziarski P, Paściak M, Chudzik A, Kozińska M, Augustynowicz-Kopeć E, Gamian A. Cutaneous tuberculosis-ambiguous transmission, bacterial diversity with biofilm formation in humoral abnormality: case report illustration. Front Public Health 2023; 11:1091373. [PMID: 37213612 PMCID: PMC10194659 DOI: 10.3389/fpubh.2023.1091373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/27/2023] [Indexed: 05/23/2023] Open
Abstract
Background Cutaneous tuberculosis (CTB) and its paucibacillary forms are rare and difficult to diagnose, especially in immunocompromised patients with significant comorbidity. The aim of the study was to introduce the modern concept of the microbiome and diagnostic chain into clinical practice (patient-centered care) with the presentation of an atypical form of cutaneous tuberculosis with necrotizing non-healing ulcers leading to polymicrobial infection. Methods The study material included samples from sputum, broncho-alveolar lavage and skin ulcer, taken from a patient developing cutaneous tuberculosis. The microbiological investigation was performed, and identification of the isolates was carried out using genotyping and the matrix-assisted laser desorption ionization-time of flight mass spectrometry. Results The immunocompromised patient with humoral abnormality (plasma cell dyscrasia) and severe paraproteinemia developed multiorgan tuberculosis. Although cutaneous manifestation preceded systemic and pulmonary symptoms (approximately half a year), the mycobacterial genotyping confirmed the same MTB strain existence in skin ulcers and the respiratory system. Therefore, the infectious chain: transmission, the portal of entry, and bacterial spreading in vivo, were unclear. Microbial diversity found in wound microbiota (among others Gordonia bronchialis, Corynebacterium tuberculostearicum, Staphylococcus haemolyticus, and Pseudomonas oryzihabitans) was associated with the spread of a skin lesion. The in vitro biofilm-forming capacity of strains isolated from the wound may represent the potential virulence of these strains. Thus, the role of polymicrobial biofilm may be crucial in ulcer formation and CTB manifestation. Conclusions Severe wound healing as a unique biofilm-forming niche should be tested for Mycobacterium (on species and strain levels) and coexisting microorganisms using a wide range of microbiological techniques. In immunodeficient patients with non-typical CTB presentation, the chain of transmission and MTB spread is still an open issue for further research.
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Affiliation(s)
- Przemysław Zdziarski
- Department of Clinical Immunology, Tuberculosis and Pulmonary Disease, Lower Silesian Oncology Center, Wroclaw, Poland
- *Correspondence: Przemysław Zdziarski
| | - Mariola Paściak
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Anna Chudzik
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Monika Kozińska
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Ewa Augustynowicz-Kopeć
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Andrzej Gamian
- Department of Immunology of Infectious Diseases, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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5
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Duan X, Xiong X, Yu H, Deng L. Unilateral Lower Extremity Elephantiasis. Clin Infect Dis 2022; 75:2035-2037. [PMID: 36449404 DOI: 10.1093/cid/ciac251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Xi Duan
- Department of Dermatology, First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China.,Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xincai Xiong
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hai Yu
- Department of Dermatology, First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
| | - Liehua Deng
- Department of Dermatology, First Affiliated Hospital of Jinan University & Jinan University Institute of Dermatology, Guangzhou, China
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6
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Imran M, Khan SA, Asdaq SMB, Almehmadi M, Abdulaziz O, Kamal M, Alshammari MK, Alsubaihi LI, Hussain KH, Alharbi AS, Alzahrani AK. An insight into the discovery, clinical studies, compositions, and patents of macozinone: A drug targeting the DprE1 enzyme of Mycobacterium tuberculosis. J Infect Public Health 2022; 15:1097-1107. [PMID: 36122509 DOI: 10.1016/j.jiph.2022.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/12/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022] Open
Abstract
Decaprenyl-phosphoryl-ribose 2'-epimerase (DprE1) inhibitors are an innovative and futuristic orally active group of antituberculosis agents. A few DprE1 inhibitors are in the clinical trial for tuberculosis (TB), including macozinone. This review highlights the discovery, developmental status, clinical studies, patents, and prospects of macozinone (MCZ). The patent and non-patent literature search was done by entering keywords such as macozinone; MCZ; PBTZ169; PBTZ-169 in Pubmed, Espacenet, Patentscope, and the USPTO databases. However, data on Sci-Finder was searched using CAS registry number: 1377239-83-2. MCZ clinical trial studies were retrieved from the clinicaltrials.gov database using the exact keywords. The chemical structure of MCZ was disclosed in 2009. Accordingly, patents/patent applications published from 2009 to June 12, 2022, have been discussed herein. MCZ and MCZ hydrochloride salt patents were granted in 2014 and 2019, respectively, in the USA. The patent literature and the clinical trial studies suggest capsule, tablet, and suspension formulations of crystalline MCZ and its hydrochloride salt as the possible and prospective dosage forms to treat TB. Some combinations of MCZ with other drugs (chloroquine, telacebec, tafenoquine, TBI-166, and sanfetrinem) with improved anti-TB efficacy have been documented. Based on the literature covered in this review article on the clinical studies and patents applied/granted to MCZ, it can be inferred that MCZ seems to be a promising DprE1 inhibitor and could help to tackle the emerging dilemma of drug-resistant either as a monotherapy or in combination with additional anti-TB agents. Furthermore, the authors anticipate the development of new combinations, salts, and polymorphs of MCZ as anti-TB agents shortly. This review article might prove beneficial to the scientific community as it summarizes chemistry, pharmacology and provides an update on the clinical studies and patents/patent applications of one of the emerging anti-TB drugs in one place.
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Affiliation(s)
- Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia.
| | - Shah Alam Khan
- Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, Muscat, Oman.
| | | | - Mazen Almehmadi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
| | - Osama Abdulaziz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
| | - Mehnaz Kamal
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
| | | | - Lojain Ibrahim Alsubaihi
- Department of Pharmaceutical Care, Prince Sultan Armed Forces Hospital, Medina 42313, Saudi Arabia.
| | - Khansa Hamza Hussain
- Department of Cardiac Science, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Abrar Saleh Alharbi
- Department of Pharmaceutical Sciences, Primary Healthcare Center, West Zone, Mecca 24341, Saudi Arabia.
| | - A Khuzaim Alzahrani
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia.
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7
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Dhar A, Khan UH, Shabir A, Mantoo S, Mehfooz N. Tuberculosis of Finger Presenting As Non-healing Ulcer of Digit: A Case Report. Cureus 2022; 14:e29426. [PMID: 36312641 PMCID: PMC9595223 DOI: 10.7759/cureus.29426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis (TB) is a chronic granulomatous infection which most often localises to the respiratory system. Extra-pulmonary tuberculosis is prevalent in immunocompromised individuals, of which cutaneous tuberculosis is exceedingly rare (0.5-2%). Cutaneous TB presents with varied clinical morphologies, either acquired exogenously via direct inoculation on the skin or endogenously due to systemic dissemination. Diagnosis is particularly challenging due to the multitude of differential diagnoses of skin lesions. Microbiological evidence from biopsy and histopathological findings suggestive of granulomatous inflammation are needed to make a definitive diagnosis. Herein we present a rare case of tuberculosis of the finger in a middle-aged man who presented with an ulcerating and erythematous lesion. As cutaneous TB is usually misdiagnosed at the earlier stages, dermatologists and primary care physicians should keep high suspicion for cutaneous TB in any non-healing ulcers which are otherwise unexplained.
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8
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Xue T, Lu Z, Zhang W, Wang Z, Shi Y, Jiang H, Wang H. Facial Erythema Due to Lupus Vulgaris and Candida albicans Infections: A Case Report. Clin Cosmet Investig Dermatol 2022; 15:1397-1402. [PMID: 35910508 PMCID: PMC9325874 DOI: 10.2147/ccid.s372359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022]
Abstract
Co-infection of Mycobacterium tuberculosis (MTB) and Candida albicans with erythema on the face is rare. A familiar red spot on the face can easily lead to missed diagnosis and misdiagnosis. Untreated lupus vulgaris (LV) can form scar tissue. And the fungal infection that cannot be diagnosed and treated timely can also lead to failure of LV treatment, resulting in facial scarring, disfigurement, and psychological stress. In this study, we reported a case of a 58-year-old immunocompetent female co-infected with MTB and Candida albicans on her face. After anti-tuberculous and anti-fungal therapy, she recovered with no scar on her face.
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Affiliation(s)
- Tianping Xue
- Department of Dermatology, Suzhou Wuzhong People's Hospital, Suzhou, Jiangsu, People's Republic of China
| | - Zhenzhong Lu
- Department of Dermatology, Suzhou Wuzhong People's Hospital, Suzhou, Jiangsu, People's Republic of China
| | - Wenyue Zhang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China
| | - Zhenzhen Wang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China
| | - Ying Shi
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China
| | - Haiqin Jiang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China
| | - Hongsheng Wang
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China.,Centre for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
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9
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Rustad AM, Hughes ZH, Osborn RL, Bhasin A. Non-pulmonary Disseminated Tuberculosis Complicated by Constrictive Pericarditis and Cutaneous Gumma. J Gen Intern Med 2022; 37:2568-2572. [PMID: 35501629 PMCID: PMC9060403 DOI: 10.1007/s11606-022-07619-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/12/2022] [Indexed: 12/02/2022]
Abstract
A 23-year-old previously healthy male presented to the hospital with symptoms of heart failure. He was diagnosed with pericarditis and found to have a reduced left ventricular ejection fraction of 25%. He was noted to have mediastinal lymphadenopathy. Pulmonary and abdominal sampling were non-diagnostic for infection, autoimmune disease, or malignancy. A QuantiFERON Gold returned positive. After a thorough travel history and detailed exam, the patient was diagnosed with disseminated tuberculosis after the discovery of a cutaneous gumma that was found to have acid-fast bacilli present on biopsy with Fite's stain. 18F-FDG PET CT and cardiac MRI were pursued given that pericardial and myocardial biopsy could not be safely performed due to the patient's hemodynamics. 18F-FDG PET CT and cardiac MRI did not demonstrate any myocardial pathology responsible for the left ventricular ejection fraction. This case highlights that pulmonary involvement is not necessary for disseminated TB, Fite's stain may be used to identify M. tuberculosis, and that cardiac MRI and 18F-FDG PET CT may be useful to delineate myocardial involvement in high-risk situations.
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Affiliation(s)
- Andrea M Rustad
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zachary H Hughes
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rebecca L Osborn
- Division of Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ajay Bhasin
- Division of Hospital Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Division of Hospital-Based Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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10
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George S, Muhaj FF, Nguyen CD, Tyring SK. Part I Antimicrobial resistance: Bacterial pathogens of dermatologic significance and implications of rising resistance. J Am Acad Dermatol 2022; 86:1189-1204. [PMID: 35122894 PMCID: PMC8808428 DOI: 10.1016/j.jaad.2021.11.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 12/24/2022]
Abstract
Although the COVID-19 pandemic has been the defining global health crisis of our time, public health officials have been sounding the alarm of another ominous threat for years: an impending antimicrobial resistance crisis. In dermatology, antibiotics are often used for prolonged courses in the treatment of skin and soft tissue infections and common inflammatory skin conditions, increasing the risk of microbiome alteration and antibiotic-related adverse effects, all while exerting consequential selective pressures on both pathogenic and bystander bacteria. In this review, we hope to raise awareness of the crisis of antimicrobial resistance and review resistance concerns related to dermatology-relevant bacterial pathogens.
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Affiliation(s)
- Saira George
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas
| | - Fiorinda F Muhaj
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas; Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas
| | | | - Stephen K Tyring
- Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas; Center for Clinical Studies, Houston, Texas.
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11
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Varpuluoma O, Sinikumpu SP, Jackson P, Tasanen K, Huilaja L. Ulcerative Tuberculosis in a Patient Treated with Adalimumab. Acta Derm Venereol 2022; 102:adv00700. [DOI: 10.2340/actadv.v102.1616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short Communication)
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12
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Gürel G, Özdemir Ç, Durusu İN. Cutaneous tuberculosis induced by adalimumab. Dermatol Ther 2022; 35:e15503. [PMID: 35393727 DOI: 10.1111/dth.15503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Gülhan Gürel
- Department of Dermatology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Çiğdem Özdemir
- Department of Pathology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - İrem Nur Durusu
- Department of Dermatology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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13
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Santosh T, Shankaralingappa A, Anthony M, Josephain K, Nagendran P, Gopinath H. Recurrent papulonecrotic tuberculid in an adolescent male: A diagnostic dilemma. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Tsur N, Barzilai A, Astman N. A "Turkey Ear" Persisting for 5 Decades. JAMA Dermatol 2021; 157:460-461. [PMID: 33656552 DOI: 10.1001/jamadermatol.2020.5832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nir Tsur
- Department of Otolaryngology and Head and Neck Surgery, Beilinson Medical Center, Petach-Tiqwa, Israel
| | - Aviv Barzilai
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Nadav Astman
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel.,Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
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15
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Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance. JOURNAL OF RESPIRATION 2021. [DOI: 10.3390/jor1020015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pathogenic Mycobacterium tuberculosis complex organisms (MTBC) primarily cause pulmonary tuberculosis (PTB); however, MTBC are also capable of causing disease in extrapulmonary (EP) organs, which pose a significant threat to human health worldwide. Extrapulmonary tuberculosis (EPTB) accounts for about 20–30% of all active TB cases and affects mainly children and adults with compromised immune systems. EPTB can occur through hematogenous, lymphatic, or localized bacillary dissemination from a primary source, such as PTB, and affects the brain, eye, mouth, tongue, lymph nodes of neck, spine, bones, muscles, skin, pleura, pericardium, gastrointestinal, peritoneum, and the genitourinary system as primary and/or disseminated disease. EPTB diagnosis involves clinical, radiological, microbiological, histopathological, biochemical/immunological, and molecular methods. However, only culture and molecular techniques are considered confirmatory to differentiate MTBC from any non-tuberculous mycobacteria (NTM) species. While EPTB due to MTBC responds to first-line anti-TB drugs (ATD), drug susceptibility profiling is an essential criterion for addressing drug-resistant EPTB cases (DR-EPTB). Besides antibiotics, adjuvant therapy with corticosteroids has also been used to treat specific EPTB cases. Occasionally, surgical intervention is recommended, mainly when organ damage is debilitating to the patient. Recent epidemiological studies show a striking increase in DR-EPTB cases ranging from 10–15% across various reports. As a neglected disease, significant developments in rapid and accurate diagnosis and better therapeutic interventions are urgently needed to control the emerging EPTB situation globally. In this review, we discuss the recent advances in the clinical diagnosis, treatment, and drug resistance of EPTB.
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16
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Bittencourt TL, da Silva Prata RB, de Andrade Silva BJ, de Mattos Barbosa MG, Dalcolmo MP, Pinheiro RO. Autophagy as a Target for Drug Development Of Skin Infection Caused by Mycobacteria. Front Immunol 2021; 12:674241. [PMID: 34113346 PMCID: PMC8185338 DOI: 10.3389/fimmu.2021.674241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022] Open
Abstract
Pathogenic mycobacteria species may subvert the innate immune mechanisms and can modulate the activation of cells that cause disease in the skin. Cutaneous mycobacterial infection may present different clinical presentations and it is associated with stigma, deformity, and disability. The understanding of the immunopathogenic mechanisms related to mycobacterial infection in human skin is of pivotal importance to identify targets for new therapeutic strategies. The occurrence of reactional episodes and relapse in leprosy patients, the emergence of resistant mycobacteria strains, and the absence of effective drugs to treat mycobacterial cutaneous infection increased the interest in the development of therapies based on repurposed drugs against mycobacteria. The mechanism of action of many of these therapies evaluated is linked to the activation of autophagy. Autophagy is an evolutionary conserved lysosomal degradation pathway that has been associated with the control of the mycobacterial bacillary load. Here, we review the role of autophagy in the pathogenesis of cutaneous mycobacterial infection and discuss the perspectives of autophagy as a target for drug development and repurposing against cutaneous mycobacterial infection.
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Affiliation(s)
| | | | | | | | - Margareth Pretti Dalcolmo
- Helio Fraga Reference Center, Sergio Arouca National School of Public Health, Fiocruz, Rio de Janeiro, Brazil
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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17
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Halle A, Lombart F, Chaby G, Bendamman M, Lok C, Hamdad F. An Erythemato-papular and Nodular Lesion on the Earlobe. Clin Infect Dis 2021; 71:1969-1972. [PMID: 33151326 PMCID: PMC7643730 DOI: 10.1093/cid/ciaa154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Aurélie Halle
- Dermatology Department, Amiens-Picardie University Medical Center, Amiens, France
| | - Florian Lombart
- Dermatology Department, Amiens-Picardie University Medical Center, Amiens, France
| | - Guillaume Chaby
- Dermatology Department, Amiens-Picardie University Medical Center, Amiens, France
| | - Mickaël Bendamman
- Pathology Department, Amiens-Picardie University Medical Center, Amiens, France
| | - Catherine Lok
- Dermatology Department, Amiens-Picardie University Medical Center, Amiens, France
| | - Farida Hamdad
- Clinical Bacteriology Department, Amiens-Picardie University Medical Center, Amiens, France
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18
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Thakur V, Choudhary R, Aggarwal D, Chatterjee D, Vinay K. Lobulated swelling of the ear: a diagnostic challenge. Int J Dermatol 2021; 60:1221-1223. [PMID: 33880758 DOI: 10.1111/ijd.15597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Vishal Thakur
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajat Choudhary
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Aggarwal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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19
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Mahdi E, Alabdan L, Amer S, Alashqar MB, Almustanyir S. A Case Report of Tuberculosis in the Finger. Cureus 2021; 13:e14071. [PMID: 33903834 PMCID: PMC8062315 DOI: 10.7759/cureus.14071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Tuberculosis is a chronic, infectious disease that predominantly affects the respiratory system. Of the least common extrapulmonary forms of the disease is cutaneous tuberculosis. We present an unusual case, which is of cutaneous tuberculosis in the finger, manifesting as an ulcerating, erythematous lesion. This had later spread to the adjacent soft tissue and bones, causing osteomyelitis of the phalanges. It is important that physicians maintain a high index of suspicion when faced with atypical skin lesions to avoid the sequelae of the local and disseminated spread of a tuberculosis infection.
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Affiliation(s)
- Elham Mahdi
- Internal Medicine, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
| | - Lulwah Alabdan
- Internal Medicine, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
| | - Sadiq Amer
- Pathology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
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20
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Cui R, Dai SM, Chen Z. Clinical Images: Papulonecrotic tuberculid and Poncet disease. ACR Open Rheumatol 2021; 3:79. [PMID: 33491877 PMCID: PMC7882537 DOI: 10.1002/acr2.11224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ran Cui
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Sheng-Ming Dai
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhiyong Chen
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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21
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Alsaadi A, Fida M, Shah K, Abu Saleh O. A 24-year-old Immigrant With Rash. Clin Infect Dis 2021; 70:1788-1791. [PMID: 32274511 DOI: 10.1093/cid/ciz687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Madiha Fida
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Kabeer Shah
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Omar Abu Saleh
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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22
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Kwak R, Kamal K, Charrow A, Khalifian S. Mass migration and climate change: Dermatologic manifestations. Int J Womens Dermatol 2021; 7:98-106. [PMID: 33537399 PMCID: PMC7838242 DOI: 10.1016/j.ijwd.2020.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 12/26/2022] Open
Abstract
Major changes in climate resulting in mass migrations have unique dermatologic implications for global vulnerable populations. Dermatologic manifestations commonly accompany the infectious and communicable diseases that proliferate in the settings of confinement, crowding, and limited sanitation associated with mass migration. Ectoparasitic infestations abound in refugee camps, and poor nutrition, hygiene, and compromised immunity put refugees at an increased risk for more dangerous infectious diseases carried by these ectoparasites. Climate change also profoundly affects the worldwide distribution of various vector-borne illnesses, thereby leading to the emergence of various communicable diseases in previously nonendemic areas. Natural disasters not only disrupt important lifesaving treatments, but also challenge various infectious disease control measures that are critical in preventing rapid transmission of highly infectious diseases. This article reviews the infectious diseases commonly found in these scenarios and provides an in-depth discussion of important implications for the dermatologist.
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Affiliation(s)
- Ruby Kwak
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Kanika Kamal
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Alexandra Charrow
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Saami Khalifian
- Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, CA, United States
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23
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Elkhachine Y, Sinaa M, Sakkah A, Hallab I, Ouarssani A, Jakar A, Elbenaye J. [Tuberculosis of the glans penis]. Ann Dermatol Venereol 2020; 147:672-675. [PMID: 32919751 DOI: 10.1016/j.annder.2020.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/26/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Y Elkhachine
- Service de dermatologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc; Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc.
| | - M Sinaa
- Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc; Service d'anatomie pathologique, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc
| | - A Sakkah
- Service de dermatologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc; Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc
| | - I Hallab
- Service de dermatologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc; Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc
| | - A Ouarssani
- Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc; Service de pneumo-phtisiologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc
| | - A Jakar
- Service de dermatologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc
| | - J Elbenaye
- Service de dermatologie, hôpital militaire Moulay-Ismail, 50000 Meknès, Maroc; Faculté de médecine et de pharmacie, université Sidi-Mohammed-Ben-Abdellah USMBA, 30000 Fès, Maroc
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24
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[A chronic wound from Vietnam]. Hautarzt 2020; 71:443-446. [PMID: 32356072 DOI: 10.1007/s00105-020-04597-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Chronic skin lesions that occur in patients who have previously stayed in tropical countries pose a diagnostic challenge for physicians. In particular, if there is a granulomatous inflammatory reaction histologically, infectious diseases should also be included in the differential diagnosis. Particularly in persons returning from high-risk regions such as Vietnam, this includes cutaneous tuberculosis, which entails a thorough examination of the patient and comprehensive therapy. This case study shows which steps should be considered if cutaneous tuberculosis is suspected.
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25
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Kolalapudi SA, Konala S, Kotha S, Arumilli PC, Kalagarla S. Unusual presentations of cutaneous tuberculosis. Indian J Tuberc 2020; 67:433-437. [PMID: 32825889 DOI: 10.1016/j.ijtb.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/05/2020] [Indexed: 12/01/2022]
Abstract
Cutaneous tuberculosis occurs in 1-2% of world cases of tuberculosis and more common in tropical countries. It presents with different clinical forms. Unusual clinical presentations are not uncommon and awareness of these will help in suspecting and managing these patients successfully. Lupus pernio like lupus vulgaris, tuberculosis of glans penis and lichen scrofulosorum on the distal parts of limbs are presented here because of their unusual clinical presentation.
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Affiliation(s)
| | - Subhashini Konala
- Department of DVL, GSL Medical College, Rajahmahendravaram, AP, 533296, India
| | - Sravanthi Kotha
- Department of DVL, GSL Medical College, Rajahmahendravaram, AP, 533296, India
| | | | - Sravani Kalagarla
- Department of DVL, GSL Medical College, Rajahmahendravaram, AP, 533296, India
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26
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Bourlond F, Velter C, Lipsker D. [A case of cutaneous tuberculosis evolving for 50 years]. Ann Dermatol Venereol 2020; 147:653-657. [PMID: 32386803 DOI: 10.1016/j.annder.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/29/2019] [Accepted: 12/31/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Tuberculosis is an infection caused by Mycobacterium (M.) tuberculosis. It is rare in France. Clinical presentations vary, making demonstration of the cause of M. Tuberculosis difficult and rendering diagnosis and management difficult. PATIENTS AND METHODS A 58-year-old man, born in Morocco, consulted for ulceration of the right forefoot that had been present since the age of 3 years. He had previously consulted at several dermatology departments. He had undergone numerous skin biopsies and bacteriological and mycobacteriological cultures but these did not contribute to the diagnosis. Slow extension and oozing were observed over time and resulted in functional disability. Given the evocative clinical aspect and despite further negative screening for mycobacteria, anti-TB quadrotherapy was prescribed and resulted in complete cure of the lesion. DISCUSSION This case underscores the difficulty of diagnosing cutaneous tuberculosis. Such a diagnosis must be clinically suspected in the presence of long lasting destructive or verrucous skin lesions that fail to heal, even where cultures are negative, and anti-TB therapy should be putatively prescribed.
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Affiliation(s)
- F Bourlond
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - C Velter
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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27
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Granado J, Catarino A. Cutaneous tuberculosis presenting as lupus vulgaris. Int J Infect Dis 2020; 96:139-140. [PMID: 32251800 DOI: 10.1016/j.ijid.2020.03.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Joana Granado
- Infectious Diseases and Tropical Medicine Department, Hospital de Egas Moniz - Centro de Lisboa Ocidental, Rua da Junqueira 126, 1349-019 Lisbon, Portugal.
| | - Alexandre Catarino
- Dermatology Department, Hospital de Egas Moniz - Centro de Lisboa Ocidental, Rua da Junqueira 126, 1349-019 Lisbon, Portugal
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28
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Enriquez M, McNulty M. Cold Case: Mystery in the Midwest of Metastatic Tuberculous Abscesses. Am J Med 2020; 133:301-303. [PMID: 31449769 DOI: 10.1016/j.amjmed.2019.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Matthew Enriquez
- Section of Infectious Diseases & Global Health, University of Chicago Medicine, Chicago, Ill.
| | - Moira McNulty
- Section of Infectious Diseases & Global Health, University of Chicago Medicine, Chicago, Ill
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29
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Gracia-Cazaña T, Morales-Moya A, Prieto-Torres L, Sanjoaquin-Conde I. Palatal ulceration of long evolution. Indian J Dermatol 2020; 65:554-556. [PMID: 33487727 PMCID: PMC7810096 DOI: 10.4103/ijd.ijd_419_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Fernandez-Nieto D, de Perosanz-Lobo D, Ortega-Quijano D, Jimenez-Cauhe J, Fernandez-Gonzalez P, Bea-Ardebol S. Tuberculous chancre in a foot leading to a disseminated tuberculosis infection. Ital J Dermatol Venerol 2019; 156:89-91. [PMID: 31760728 DOI: 10.23736/s2784-8671.19.06460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - Juan Jimenez-Cauhe
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Sonia Bea-Ardebol
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
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31
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Morenz A, Yu SH, Cornejo K, Mackool B. A 36-Year-Old Moroccan Man Presenting with Widespread Papules and Pustules. Dermatopathology (Basel) 2019; 6:201-205. [PMID: 31616661 PMCID: PMC6787429 DOI: 10.1159/000502347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/23/2019] [Indexed: 11/23/2022] Open
Abstract
Cutaneous manifestations of tuberculosis are uncommon, can be nonspecific, and may demonstrate a wide variety of morphologies, including ulcerative papules, verrucous plaques, or nodules. We report the case of a 36-year-old Moroccan man who presented with nearly 2 years of generalized folliculocentric pustules and nodules, night sweats, and weight loss. Workup revealed necrotic right axillary lymphadenopathy, multiple ill-defined hepatic lesions, and a positive interferon-γ release assay. These findings were most consistent with papulonecrotic tuberculosis.
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Affiliation(s)
- Anna Morenz
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sherry H Yu
- Harvard Combined Dermatology Residency Program, Boston, Massachusetts, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kristine Cornejo
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bonnie Mackool
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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32
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Gonda A, Zhao N, Shah JV, Calvelli HR, Kantamneni H, Francis NL, Ganapathy V. Engineering Tumor-Targeting Nanoparticles as Vehicles for Precision Nanomedicine. MED ONE 2019; 4:e190021. [PMID: 31592196 PMCID: PMC6779336 DOI: 10.20900/mo.20190021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As a nascent and emerging field that holds great potential for precision oncology, nanotechnology has been envisioned to improve drug delivery and imaging capabilities through precise and efficient tumor targeting, safely sparing healthy normal tissue. In the clinic, nanoparticle formulations such as the first-generation Abraxane® in breast cancer, Doxil® for sarcoma, and Onivyde® for metastatic pancreatic cancer, have shown advancement in drug delivery while improving safety profiles. However, effective accumulation of nanoparticles at the tumor site is sub-optimal due to biological barriers that must be overcome. Nanoparticle delivery and retention can be altered through systematic design considerations in order to enhance passive accumulation or active targeting to the tumor site. In tumor niches where passive targeting is possible, modifications in the size and charge of nanoparticles play a role in their tissue accumulation. For niches in which active targeting is required, precision oncology research has identified targetable biomarkers, with which nanoparticle design can be altered through bioconjugation using antibodies, peptides, or small molecule agonists and antagonists. This review is structured to provide a better understanding of nanoparticle engineering design principles with emphasis on overcoming tumor-specific biological barriers.
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Affiliation(s)
- Amber Gonda
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854, USA
| | - Nanxia Zhao
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, 98 Brett Road, Piscataway, NJ 08854, USA
| | - Jay V. Shah
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854, USA
| | - Hannah R. Calvelli
- Department of Molecular Biology and Biochemistry, Rutgers, The State University of New Jersey, 604 Allison Road, Piscataway, NJ 08854, USA
| | - Harini Kantamneni
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854, USA
| | - Nicola L. Francis
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854, USA
| | - Vidya Ganapathy
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854, USA
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33
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Connors WJ, Fisher DA, Kunimoto DY, Jarand JM. Program-wide review and follow-up of erythema Induratum of Bazin and tuberculosis-associated ocular inflammation management in a TB low-incidence setting: need for improved treatment candidate selection, therapy standardization, and care collaboration. BMC Infect Dis 2019; 19:97. [PMID: 30696400 PMCID: PMC6352374 DOI: 10.1186/s12879-019-3737-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Erythema induratum of Bazin (EIB) - nodular vasculitis associated with Mycobacterium tuberculosis (TB) - and Tuberculosis-Associated Ocular Inflammation (TB-AOI) represent uncommon manifestations of TB. There is limited data and a lack of diagnostic and treatment standards for these conditions. METHODS Eleven-year retrospective review of EIB and TB-AOI cases managed in a provincial TB program with prospective phone-based follow-up of anti-tubercular therapy (ATT) recipients. Presumptive TB-AOI and EIB diagnoses were determined by ophthalmologist or dermatologist assessments correlated with positive tuberculin skin test and/or QuantiFERON-TB Gold, along with pathologic criteria in EIB cases. RESULTS Of 21 EIB and 20 TB-AOI cases that received ATT, 13 and 11, respectively, were reached for follow-up. The majority of EIB and TB-AOI cases were female and immigrated from TB high-burden countries. Median durations of pre-diagnosis symptoms were 2 and 0.8 years (IQR 2.5 & 1.1) for EIB and TB-AOI cases, respectively. Overall, 14 different ATT regimens were used for a median duration of 6 months (range 5-9). ATT related adverse events resulting in treatment discontinuation occurred in 14% of EIB and 10% of TB-AOI cases. On last follow-up, 76% of EIB and 42% of TB-AOI had improvement or resolution of disease. CONCLUSION EIB and TB-AOI were uncommon presentations receiving variable therapy. While treatment response was modest for EIB cases, TB-AOI cases had sub-optimal treatment outcomes. The unique diagnostic and management challenges presented by these conditions in TB low-incidence settings highlight a need for improved treatment candidate selection, therapy standardization, and cross-specialty medical collaboration.
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Affiliation(s)
- William J. Connors
- Department of Medicine, University of Calgary, Alberta, Canada
- Calgary Tuberculosis Services, Alberta, Canada
- Foothills Medical Centre, Rm 303, 3rd Floor North Tower, 1403, 29th Street, NW, Calgary, Alberta T2N 2T9 Canada
| | - Dina A. Fisher
- Department of Medicine, University of Calgary, Alberta, Canada
- Calgary Tuberculosis Services, Alberta, Canada
| | - Dennis Y. Kunimoto
- Edmonton Tuberculosis Program, Alberta, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton Canada
| | - Julie M. Jarand
- Department of Medicine, University of Calgary, Alberta, Canada
- Calgary Tuberculosis Services, Alberta, Canada
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34
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Rabiei P, Hasanov M, Akhavan B, Aisenberg GM. Tuberculous cellulitis in an immunocompetent patient. Proc (Bayl Univ Med Cent) 2019; 32:63-64. [PMID: 30956584 DOI: 10.1080/08998280.2018.1540759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/18/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022] Open
Abstract
Mycobacterial skin infections are rare, with a wide spectrum of clinical features in immunocompromised individuals. Overall, they represent <2% of all forms of extrapulmonary tuberculosis. Tuberculous cellulitis is considered a skin manifestation of miliary tuberculosis. We present a case of tuberculous cellulitis in an immunocompetent patient.
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Affiliation(s)
- Pejman Rabiei
- Department of Medicine, McGovern Medical School, UT HealthHoustonTexas
| | - Merve Hasanov
- Department of Medicine, McGovern Medical School, UT HealthHoustonTexas
| | - Bobak Akhavan
- Department of Medicine, McGovern Medical School, UT HealthHoustonTexas
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35
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Abstract
Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.
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Affiliation(s)
- Qiquan Chen
- Department of Dermatology, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - WenChieh Chen
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.
| | - Fei Hao
- Department of Dermatology, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China
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Mervis JS, Machler BC, Hanly AJ, Federman DG. Down the Rabbit Hole: Cutaneous Tuberculosis. Am J Med 2019; 132:52-54. [PMID: 30201246 DOI: 10.1016/j.amjmed.2018.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/14/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Brian C Machler
- Department of Dermatology, New York University Langone Health School ofMedicine, New York
| | - Andrew J Hanly
- Department of Dermatology, University of Miami School of Medicine, Miami, Fla
| | - Daniel G Federman
- Yale University School of Medicine, New Haven, Conn; VA Connecticut Healthcare System, West Haven.
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Distrofia ungueal hiperqueratósica. Enferm Infecc Microbiol Clin 2018; 36:664-665. [DOI: 10.1016/j.eimc.2017.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 11/23/2022]
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Abstract
Humans encounter mycobacterial species due to their ubiquity in different environmental niches. In many individuals, pathogenic mycobacterial species may breach our first-line barrier defenses of the innate immune system and modulate the activation of phagocytes to cause disease of the respiratory tract or the skin and soft tissues, sometimes resulting in disseminated infection. Cutaneous mycobacterial infections may cause a wide range of clinical manifestations, which are divided into four main disease categories: (i) cutaneous manifestations of Mycobacterium tuberculosis infection, (ii) Buruli ulcer caused by Mycobacterium ulcerans and other related slowly growing mycobacteria, (iii) leprosy caused by Mycobacterium leprae and Mycobacterium lepromatosis, and (iv) cutaneous infections caused by rapidly growing mycobacteria. Clinically, cutaneous mycobacterial infections present with widely different clinical presentations, including cellulitis, nonhealing ulcers, subacute or chronic nodular lesions, abscesses, superficial lymphadenitis, verrucous lesions, and other types of findings. Mycobacterial infections of the skin and subcutaneous tissue are associated with important stigma, deformity, and disability. Geography-based environmental exposures influence the epidemiology of cutaneous mycobacterial infections. Cutaneous tuberculosis exhibits different clinical phenotypes acquired through different routes, including via extrinsic inoculation of the tuberculous bacilli and dissemination to the skin from other sites, or represents hypersensitivity reactions to M. tuberculosis infection. In many settings, leprosy remains an important cause of neurological impairment, deformity, limb loss, and stigma. Mycobacterium lepromatosis, a mycobacterial species related to M. leprae, is linked to diffuse lepromatous leprosy of Lucio and Latapí. Mycobacterium ulcerans produces a mycolactone toxin that leads to subcutaneous tissue destruction and immunosuppression, resulting in deep ulcerations that often produce substantial disfigurement and disability. Mycobacterium marinum, a close relative of M. ulcerans, is an important cause of cutaneous sporotrichoid nodular lymphangitic lesions. Among patients with advanced immunosuppression, Mycobacterium kansasii, the Mycobacterium avium-intracellulare complex, and Mycobacterium haemophilum may cause cutaneous or disseminated disease. Rapidly growing mycobacteria, including the Mycobacterium abscessus group, Mycobacterium chelonei, and Mycobacterium fortuitum, are increasingly recognized pathogens in cutaneous infections associated particularly with plastic surgery and cosmetic procedures. Skin biopsies of cutaneous lesions to identify acid-fast staining bacilli and cultures represent the cornerstone of diagnosis. Additionally, histopathological evaluation of skin biopsy specimens may be useful in identifying leprosy, Buruli ulcer, and cutaneous tuberculosis. Molecular assays are useful in some cases. The treatment for cutaneous mycobacterial infections depends on the specific pathogen and therefore requires a careful consideration of antimicrobial choices based on official treatment guidelines.
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Cutaneous Tuberculosis: Clinicopathologic Arrays and Diagnostic Challenges. Dermatol Res Pract 2018; 2018:7201973. [PMID: 30111996 PMCID: PMC6077618 DOI: 10.1155/2018/7201973] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 06/25/2018] [Indexed: 11/05/2022] Open
Abstract
The clinicopathological manifestations of cutaneous tuberculosis are diverse. The precise diagnosis is often overlooked, due to clinical presentations as those of cutaneous diseases with different etiology and the relative paucity of the pathogens in the lesions. Meanwhile, almost all of the diagnostic methods confer lower sensitivity and specificities which augments further diagnostic challenges. This article revises the current scenario of the disease's physiopathology and underscores clinicopathological challenges, due to multifaceted presentations of cutaneous tuberculosis, in the diagnosis.
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40
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Laidler N. Cutaneous infection with paucibacillary Mycobacterium tuberculosis treated successfully with a modified antituberculous drug regimen. BMJ Case Rep 2017; 2017:bcr-2017-221938. [PMID: 29275384 DOI: 10.1136/bcr-2017-221938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Tuberculosis is a serious infection that is increasing in prevalence, affecting many people worldwide. The diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with often inconclusive diagnostic testing. Extrapulmonary tuberculosis comprises approximately 10% of all cases of tuberculosis, and cutaneous tuberculosis makes up only a small proportion of these cases. Discussed here is the case of a 61-year-old immunocompetent female with a large cutaneous lesion on her index finger secondary to Mycobacterium tuberculosis Tissue cultures taken at biopsy were negative; however, empiric antimycobacterial therapy was initiated. The initial regimen was not tolerated, and antituberculous therapy was substituted for moxifloxacin and clarithromycin. The lesion improved significantly with a concurrent improvement in function.
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Affiliation(s)
- Nicholas Laidler
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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41
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Saracino A, Fortarezza F, Costa D, Bonamonte D. A 75-year-old woman presenting with nasal vestibulitis. Infection 2017; 46:579-580. [PMID: 29098648 DOI: 10.1007/s15010-017-1087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/21/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Annalisa Saracino
- Department of Biomedical Science and Human Oncology, Clinic of Infectious Diseases, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy.
| | - Francesco Fortarezza
- Section of Pathological Anatomy, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Danila Costa
- Mycobacteria Laboratory, Microbiology and Virology Unit, University Hospital, Policlinico, Bari, Italy
| | - Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
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Affiliation(s)
- Lisa Borretta
- Faculty of Medicine (Borretta); Division of Dermatology (Green), Dalhousie University, Halifax, NS
| | - Peter Green
- Faculty of Medicine (Borretta); Division of Dermatology (Green), Dalhousie University, Halifax, NS
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43
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Wang TT, Liu HJ, Wang L. A Rare Case of Lupus Vulgaris with Papulonecrotic Tuberculid and Discoid Lupus Erythematosus. Chin Med J (Engl) 2017; 130:2134-2135. [PMID: 28836565 PMCID: PMC5586191 DOI: 10.4103/0366-6999.213417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wanat KA, Dominguez AR, Carter Z, Legua P, Bustamante B, Micheletti RG. Bedside diagnostics in dermatology: Viral, bacterial, and fungal infections. J Am Acad Dermatol 2017; 77:197-218. [PMID: 28711082 DOI: 10.1016/j.jaad.2016.06.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/29/2016] [Accepted: 06/02/2016] [Indexed: 02/08/2023]
Abstract
Viral, bacterial, and fungal infections are frequently encountered in clinical practice, resulting in numerous cutaneous manifestations. Although diagnosis of these infections has changed over time because of technological advancements, such as polymerase chain reaction, bedside diagnostic techniques still play an important role in diagnosis and management, enabling rapid and low-cost diagnosis and implementation of appropriate therapies. This 2-part article will review both common and infrequent uses of bedside diagnostic techniques that dermatologists can incorporate into daily practice. This article examines the utility of bedside tests for the diagnosis of viral, bacterial, and fungal infections. The second article in this series reviews the use of bedside diagnostics for parasitic and noninfectious disorders.
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Affiliation(s)
- Karolyn A Wanat
- Department of Dermatology, Pathology, and Infectious Diseases, University of Iowa, Iowa City, Iowa
| | - Arturo R Dominguez
- Department of Dermatology, University of Texas Southwestern, Dallas, Texas; Department of Medicine, University of Texas Southwestern, Dallas, Texas
| | - Zachary Carter
- University of Texas Southwestern Medical School, Dallas, Texas
| | - Pedro Legua
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Beatriz Bustamante
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Cayetano Heredia, Lima, Peru
| | - Robert G Micheletti
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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45
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Abstract
Cutaneous tuberculosis (TB) may present in various clinical manifestations. Skin involvement may occur as a result of exogenous inoculation, contiguous spread from a nearby focus of infection, or by hematogenous spread from a distant focus. Because the clinical presentation of cutaneous TB can vary widely, it is important to have a high index of suspicion in appropriate clinical settings. In this chapter, the various clinical manifestations of clinical TB are classified by source of infection (exogenous, endogenous, and hematogenous spread). These are linked to the clinical appearance and histology of the skin lesions. Hopefully, this will resolve the confusion created by the myriad of terms previously used in the medical literature. Once a diagnosis of cutaneous TB is entertained, a biopsy for both culture and histopathology should be submitted. In some cases histopathology may show nonspecific inflammation without classic granuloma formation. In these cases, monoclonal antibodies and polymerase chain reaction (PCR) testing may be useful. In fact, in recent years, PCR amplification has proven to be invaluable in assisting identification of M. tuberculosis from skin biopsies in patients with negative TB cultures. In most instances, treatment of cutaneous TB requires combination chemotherapy. This is especially important in patients with extra cutaneous disease, multiple skin lesions, and those with profound immunosuppression. Surgery also may play both a diagnostic and therapeutic role.
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46
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Unusual Sites of Cutaneous Tuberculosis: A Report of Two Cases. Case Rep Dermatol Med 2017; 2017:7285169. [PMID: 28348900 PMCID: PMC5350300 DOI: 10.1155/2017/7285169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/19/2016] [Accepted: 01/09/2017] [Indexed: 12/02/2022] Open
Abstract
Cutaneous tuberculosis (CTB) is an uncommon small subset of extrapulmonary tuberculosis, comprising 1–1.5% of all extrapulmonary tuberculosis manifestations, which manifests only in 8.4–13.7% of all tuberculosis cases. Lupus vulgaris (LV) and tuberculosis verrucosa cutis (TBVC) are forms of reinfection tuberculosis and often occur in presensitized patients, by exogenous inoculation. We report two cases of cutaneous tuberculosis at unusual sites. A 35-year-old female having a forehead lesion for 2 years was diagnosed as having tuberculosis verrucosa cutis and another 16-year-old girl with lesion in left axilla for 10 years was proven to have lupus vulgaris. The delayed diagnosis was possibly due to lower clinical suspicion due to the presentation of CTB at unusual sites. This highlights the importance of keeping TB as an important differential as misdiagnosis or delayed diagnosis of this entity can lead to prolonged morbidity.
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47
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Azevedo TPD, Oliveira MLWD. Analysis of cutaneous tuberculosis cases reported from 2000 to 2013 at a university hospital in Rio de Janeiro. Rev Soc Bras Med Trop 2017; 49:373-5. [PMID: 27384838 DOI: 10.1590/0037-8682-0328-2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 03/16/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Tuberculosis (TB) is a serious public health problem; however, the cutaneous form remains rare. METHODS A retrospective analysis examined notified cutaneous tuberculosis (CTB) cases from 2000 to 2013 at the University Hospital Clementino Fraga Filho. RESULTS Twenty-six CTB cases were documented during this period. Erythema induratum of Bazin was the most common form, and 86.7% of such cases occurred in women (p=0.068). Only one patient was HIV positive. CONCLUSIONS This study confirms the rarity of CTB and highlights the need for multicenter studies in order to obtain an adequate number of cases for analysis.
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Affiliation(s)
- Thales Pereira de Azevedo
- Serviço de Dermatologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil
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48
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49
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Pourazizi M, Kabiri S, Saffaei A, Abtahi-Naeini B. Lupus and lupoid misnomer: issues and challenges. Lupus 2016; 26:6-9. [PMID: 27605369 DOI: 10.1177/0961203316665711] [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: 07/01/2016] [Accepted: 07/25/2016] [Indexed: 11/16/2022]
Abstract
Misnomers are terms for any of medical conditions whose name does not reflect the pathophysiological reality. In the field of dermatology, it is interesting to note that there are some misnomers about lupus. Lupus is Latin for wolf, and it comes from the facial appearance that was thought to resemble the bites of a wolf. Until the 19th century, lupus was most commonly caused by cutaneous tuberculosis (TB), so some of the misnomer related to TB. Other misnomers encountered in lupus have arisen from the lack of understanding of the underlying etiology, pathogenesis and histopathological features, due to imprecise translations.
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Affiliation(s)
- M Pourazizi
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Ophthalmology, Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - S Kabiri
- Orthodontic Department, Dental school, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Saffaei
- Pharmacy Students' Research Committee, School of Pharmacy, Isfahan University of Medical sciences, Isfahan, Iran
| | - B Abtahi-Naeini
- Skin diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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50
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Spelta K, Diniz LM. CUTANEOUS TUBERCULOSIS: A 26-YEAR RETROSPECTIVE STUDY IN AN ENDEMIC AREA OF TUBERCULOSIS, VITÓRIA, ESPÍRITO SANTO, BRAZIL. Rev Inst Med Trop Sao Paulo 2016; 58:49. [PMID: 27410909 PMCID: PMC4964318 DOI: 10.1590/s1678-9946201658049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/20/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Tuberculosis is a serious health problem in Brazil so that the knowledge on the aspects of cutaneous tuberculosis is medically important. OBJECTIVE To assess the characteristics of patients with cutaneous tuberculosis treated at the Cassiano Antonio Moraes University Hospital, located in the city of Vitória, State of Espírito Santo, Brazil. METHODS This is a retrospective, descriptive, observational and cross-sectional study using the medical records of 29 patients with cutaneous tuberculosis treated at the Dermatology and Pulmonology services of the hospital from 1986 to 2011. The inclusion criterion was the confirmation of cutaneous tuberculosis taking into account clinical, epidemiological, immunological, and bacteriological findings, as well as the response to specific treatment. RESULTS Of the 29 studied patients; 18 (62%) were women with average age of 37 years; the predominant clinical condition was erythema induratum of Bazin in 12 (41.4%) cases; and the cutaneous lesions were in the lower limbs in 19 (65.8%) patients. Extra-cutaneous involvement occurred in eight (27.6%) cases. The tuberculin tests were positive in 15 (79%) individuals and the assessment of the infectious agent was negative in most of the investigated cases. CONCLUSION The study found a low frequency (0.44%) of cutaneous tuberculosis in an endemic area of tuberculosis. There was a predominance of infection in women aged thirty to forty years. Erythema induratum was the most common clinical condition, affecting mainly the lower limbs, in contrast to other Brazilian studies that found scrofuloderma as the most common manifestation, predominating in the cervical region of male children and adolescents.
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Affiliation(s)
- Karla Spelta
- Federal University of Espírito Santo, Medical Graduate Program. Vitória, ES, Brazil
| | - Lucia M Diniz
- Federal University of Espírito Santo, Medical Graduate Program. Vitória, ES, Brazil
- Federal University of Rio de Janeiro, Medical Graduate Program. Rio de Janeiro, RJ, Brazil
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