Occurrence of Extensive Scrofuloderma in an Immunocompromised Child: A Rare Case Report

Abstract

Scrofuloderma also called Tuberculosis colliquativa cutis is one of the variants of cutaneous tuberculosis. It can be a skin manifestation of concealed tuberculosis infection. It is most common in countries under development, such as India. It is possible that the individual suffering from Scrofuloderma may not have underlying tuberculosis however, the patient may have come in contact with a tuberculosis patient in the past and due to his/her immunocompromised state the disease manifests. Here, we describe the case of a four-year-old boy presented to the Outpatient Department (OPD) with all the classical sign and symptoms of tuberculosis as low-grade fever, multiple ulcerated nodules at the site of lymph nodes over the neck, axillae, anterior chest wall and inguinal region with history of rupture and extensive crusting. On the basis of presentation and examination the differential diagnosis was made in which Scrofuloderma was first listed. To confirm the diagnosis all the relevant investigations were advised in which Mantoux test, Erthrocyte Sedimentation Rate (ESR) came positive and chest X-ray revealed old resolved tuberculosis. After correlating, clinical findings and laboratory investigations a confirmed diagnosis of scrofuloderma was made and the patient was treated with standard Anti-Tubecular Treatment (ATT). After the completion of standard prescribed period of treatment and specific puckered healing of the ulcerated lesions again confirmed the diagnosis. The aim of reporting is presentation of lesions as superficial bacterial infection and healed old tuberculosis.