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

Background: Tuberculosis (TB) is a health problem worldwide. Cutaneous TB comprises a small fraction of all clinical forms of TB. Objective: The purpose of this study was to assess the disease pattern of cutaneous TB in an Asian country. Materials and Methods: Totally, 50 cases of cutaneous TB were diagnosed on histopathology in a tertiary care hospital over a period of 7 years. Relevant clinical details and available laboratory findings were correlated. Results: The patients ranged from 4 to 78 years with 26 males and 24 females. Neck was the most common site. 22 (44%) cases presented with erythematous plaques followed by papules in 9 (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 6 (12%). 24 (48%) patients were diagnosed lupus vulgaris, 11 (22%) scrofuloderma, 4 (8%) TB verrucosa cutis, 1 (2%) TB cutis orificialis, and 10 (20%) TB non-specific type. Conclusion: Lupus vulgaris is a most common presentation of cutaneous TB. 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.