Tuberculosis verrucosa cutis: case report of a diagnostic challenge

Vasudha A. Belgaumkar, Ravindranath B. Chavan, Prernaa R. Suryataley, Aarti S. Salunke, Pallavi P. Patil, Sandhya M. Borade


Cutaneous tuberculosis occurs by either exogenous inoculation in a previously sensitized or non-immune host or endogenous spread from an internal focus by contiguous, hematogenous or lymphatic route. Inoculation occurs at sites of minor wounds or abrasions, sometimes from the patient’s own sputum. Cutaneous tuberculosis includes lupus vulgaris and tuberculosis verrucosa cutis (TVC) at one end and scrofuloderma and tuberculosis cutis orificialis at the other end with decrease in cell-mediated immunity across the spectrum. Of various cutaneous forms, we report a case of tuberculosis verrucosa cutis in a 14 year old girl who presented with a hyperpigmented verrucous plaque over foot since three years. Histopathological characteristics, GeneXpert and response to antitubercular therapy confirmed the diagnosis.



Cutaneous tuberculosis, Tuberculosis verrucosa cutis, Daily fixed dose combination

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Padmavathy L, Rao LL, Pari T, Ethirajan N. Lupus vulgaris and tuberculosis verrucosa cutis (TBVC)-clinical, pathological and epidemiological study of 71 cases. Indian J Tuberculosis. 2008;55:203-9.

Singhal A, Sonthalia S. Cutaneous TB in children: the Indian perspective. Ind J Dermatol Ven Lep. 2010;76:494-503.

Yates VM, Walker SL. Mycobacterial infections. Rook’s Textbook of Dermatology. 4 Volume. 9th edition. Wiley-Blackwell; 2016.

Padmavathy L, Rao LL, Ethirajan N, Rao R. Tuberculosis verrucosa cutis: foot with miliary tuberculosis. Indian J Tuberc. 2007;54:145-8.

Abdalla CM, de Oliviera ZN, Sotto MN, Leite KR, Canavez FC, de Carvalho CM. PCR compared to other laboratory findings and to clinical evaluation in the diagnosis of tuberculosis and atypical mycobacteria skin infection. Int J Dermatol. 2009;48:27–35.

Janjua SA, Kachemoune A, Guillen S. Tuberculosis verrucosa cutis presenting as an annular hyperkeratotic plaque. Cutis. 2006;78(5):309-16.

Bravo FG, Gotuzzo F. Cutaneous tuberculosis. Clin Dermatol. 2007;25:173-80.

Tan SH, Tan BH, Goh CL, Tan KC, Tan MF, Ng WC. Detection of M tuberculosis DNA using polymerase chain reaction in cutaneous TB and tuberculids. Int J Dermatol. 1999;38(2):122-7.

Padmavathy L, Rao L, Velliati A. Utility of PCR as a diagnostic tool in cutaneous tuberculosis. Ind J Dermatol Ven Lep. 2003;69:214-6.

Technical and Operational Guidelines for Tuberculosis Control in India 2016. Available at: Accessed on 10th February 2016.