A clinicoepidemiological study of cutaneous tuberculosis in a tertiary care teaching hospital in Andhra Pradesh, India

Background: Cutaneous tuberculosis constitutes 1.5% of extra pulmonary tuberculosis and the disease continues to be a challenging one because of its multifaceted presentation. The present study was done to document the most common type of cutaneous tuberculosis, atypical presentations if any and response to directly observed therapy short course (DOTS) . Methods: All patients with clinically suspected cutaneous tuberculosis attending outpatient department of dermatology in our hospital from October 2012 to April 2016 were included in the study. A detailed history of presenting illness and thorough general, systemic and cutaneous examination was carried out along with documentation of demographic details. Routine blood invetigations, biopsy and mantoux test were done. Diagnosed cases were treated with DOTS. Results: A total of 25 cases of cutaneous tuberculosis were included in the study. Most common type of cutaneous tuberculosis was lupus vulgaris. Atypical presentations noted during the study were multifocal lupus vulgaris (LV), co-existence of tuberculosis verrucosa cutis (TVC) and LV, TVC of lower lip, erythema induratum of bazin presenting as annular plaque in one case and as erythema nodosum in another case. DOTS were effective in majority of the patients . Conclusions: Cutaneous tuberculosis is multifaceted. High clinical suspicion is necessary in rare presentations. Coexistence of two or more morphological patterns can occur. Doubtful cases, 5-6weeks of therapeutic trail helps. Adequate dose is essential for good response. Second line drugs are to be considered in case of failure /clinical resistance .