Cutaneous Tuberculosis: A Clinicopathological Study in A Tertiary Care Hospital

Abstract

Tuberculosis (TB) is a chronic disease that can affect multiple organs including, the skin. Cutaneous TB poses a great challenge to dermatologists due to its varied clinical presentations and non-specific histopathological findings. Objective: To determine the frequency of clinicopathological patterns of Cutaneous Tuberculosis in children and adults in a Tertiary Care Hospital. Methods: A descriptive cross-sectional study included 63 patients diagnosed with Cutaneous TB at the Department of Dermatology, Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan from January 2020 to December 2022. All the patients were clinically evaluated and histopathological features were recorded. Results: The common age group was 21-30 years, with male predominance. Lupus Vulgaris was the most common clinicopathological type in 46 cases (73%), followed by Scrofuloderma in 9 cases (14.3%). Tuberculous Verrucosa cutis and Tuberculous Gumma accounted for 4.8% of cases, while Acute Military Tuberculosis and Tuberculous Panniculitis accounted for 1.6% of cases. The most predominant morphology of the lesion was Erythematous Plaque (36.5%) and the most commonly affected site was face (30.2%). Epitheloid Granuloma with langerhans giant cells were typically present in most of the cases, with Caseous Necrosis more predominantly seen in Scrofuloderma (44.4%), TB Gumma (66.6%) and Acute Military TB (100%). Conclusions: Lupus Vulgaris is the most common presentation of Cutaneous TB followed by Scrofuloderma. Epitheloid Granuloma with langerhans giant cells, with or without Caseous Necrosis is the predominant histopathological presentation. Clinical and histopathological assessment is crucial for an appropriate diagnosis.