Cutaneous tuberculosis: a clinicopathological study of 50 cases from a tertiary care referral hospital

Background: Tuberculosis is a health problem worldwide. Cutaneous tuberculosis comprises a small fraction of all clinical forms of tuberculosis. Objective: The purpose of this study was to assess the disease pattern of cutaneous tuberculosis in an Asian country. Materials and Methods: Fifty cases of cutaneous tuberculosis were diagnosed on histopathology in a tertiary care hospital over a period of seven years. Relevant clinical details and available laboratory findings were correlated. Results: The patients ranged from 4-78 years with 26 males and 24 females. Neck was the most common site. Twenty two (44%) cases presented with erythematous plaques followed by papules in nine (18%) cases. Classical epithelioid cell granulomas with Langhans giant cells were found in 46 (92%) patients, while caseation necrosis was seen in 18 (36%). On Ziehl-Neelsen staining, acid fast bacilli were demonstrated in six (12%). Twenty four (48%) patients were diagnosed lupus vulgaris, 11 (22%) scrofuloderma, four (8%) tuberculosis verrucosa cutis, one (2%) tuberculosis cutis orificialis and 10 (20%) tuberculosis non specific type. Conclusion: Lupus vulgaris is most common presentation of cutaneous tuberculosis. Caseating epithelioid cell granulomas with or without positive Ziehl-Neelsen stain constitute the classical picture. Knowledge of different histopathological features and their variation is important for an accurate diagnosis.