Clinical presentations of cutaneous tuberculosis

Objective To determine the frequency of different clinical presentations of cutaneous tuberculosis in a tertiary care hospital. Methods This cross-sectional study was carried out in the Department of Dermatology, Civil Hospital, Karachi and Department of Dermatology, Ziauddin University, Karachi, over three years from 5th March 2007 to 4th March 2010. Patients of both sexes and all age groups suffering from histologically-confirmed cutaneous tuberculosis for last 1 month to 10 years were enrolled. A detailed history and examination were recorded on a predesigned proforma. The collected data were computed and analyzed. Results 57 diagnosed (biopsy proven) cases of cutaneous tuberculosis comprising 35 females (61.4%) and 22 males (38.6%) were enrolled. The age range was 1 up to 80 years. Among these subjects, half the patients were aged between 11-30 years. 17 patients (29.8%) had the disease for 1-2 years constituting the highest frequency for the duration of illness. Most of the patients i.e. 33 (57.5%) had more than one lesion. The lesions were most commonly seen on limbs in 25 (43.4%) patients, followed by face and neck, trunk and genitalia. Chronic discharging sinuses and plaques were the most common presentations. Scrofuloderma was the most common tuberculosis cutis seen in 35 (62%) patients followed by lupus vulgaris, warty tuberculosis and tuberculids. Overall frequency was higher in females. However, some of the types were more frequent in females while others in males. Mean age of presentation for scrofuloderma was 25.7±16.9 years, warty tuberculosis 25.7±15.9 years, lupus vulgaris 29.4±16.5 years and tuberculids 30±11.9 years (p=0.197). Conclusion Scrofuloderma is the most common clinical presentation of tuberculosis cutis seen in our setting followed by lupus vulgaris, tuberculosis verrucosa cutis and tuberculids.