A retrospective study on clinicopathological correlation of cutaneous tuberculosis
Keywords:Koch’s bacillus, Acid-fast bacilli, Granuloma, CB-NAAT, Epitheloid cells
Background: Cutaneous tuberculosis is a curable chronic infectious disease. The clinical presentation and histopathological interpretation of skin biopsy may show variations as various types of the disease exist. The clinical diagnosis should be confirmed by histopathological features before starting treatment for particular type of the disease.
Methods: A retrospective hospital based study was conducted among patients in Chengalpattu medical college for last 3 years (May 2015 – April 2018) who had cutaneous tuberculosis. Skin biopsy taken from active lesion was stained with routine haematoxylin and eosin (H & E) stain.
Results: Out of 20 cases, male to female ratio was 1.5:1. The age of the patients ranged from 11-68 years. Clinically, lupus vulgaris was the most common type of cutaneous tuberculosis with 35% cases followed by tuberculosis verrucosa cutis 20% cases, scrofuloderma 15% and atypical mycobacterial infections 10%, and least common types are lichen scrofulosorum 5% which correlates with the previous study of Aruna et al. Characteristic tuberculoid granulomas were seen in 71.4% cases of lupus vulgaris, all cases of scrofuloderma, lichen scrofulosorum and 80% of tuberculosis verrucosa cutis. The clinical and histopathological correlation was seen in 17 cases (85%).
Conclusions: There can be overlap between different types of cutaneous tuberculosis with various other dermatological diseases, both clinically and morphologically and so correlation of clinical and histopathological features appears to be more useful for accurate diagnosis and typing of cutaneous tuberculosis. High clinical suspicion is necessary in cutaneous tuberculosis and early diagnosis and treatment are essential to prevent its complications.
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