B11. Tuberculosis of the skin and its treatment
- Cutaneous tb is a rare form of extrapulmonary tb
- Multiple types
- Tuberculous chancre
- Occurs at the site where m. tuberculosis enters the skin
- In people who don’t already have TB
- Papule -> painless ulcer
- TB verrucosa cutis
- Occurs at the site where m. tuberculosis enters the skin
- In people who already have TB
- Purplish warty growth
- Lupus vulgaris
- Apple-jelly nodules (gelatinous consistency)
- Sharply defined reddish-brown lesions
- On head
- Scrofuloderma
- Direct extension of underlying TB from lymph nodes, bones or joints to the skin
- Firm, painless nodules -> ulcerate
- Miliary TB
- Haematogenous dissemination of m. tuberculosis
- Small (millet-sized) erythematous papules -> ulcers, abscesses
- Tuberculids
- Papulonecrotic tuberculid
- Necrotic papules
- Erythema induratum
- Hard nodules on back of legs of women
- Papulonecrotic tuberculid
- Tuberculous chancre
- Diagnosis
- Tuberculin skin test (TST) / purified protein derivative (PPD)
- Interferon gamma release assay (IGRA)
- Treatment
- RIPE for 2 months
- RI for 4 months