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Original Article

Dermoscopy of the diverse spectrum of cutaneous tuberculosis in the skin of color

Author Affiliation(s)

Abstract

Introduction: Cutaneous tuberculosis is an uncommon form of tuberculosis, accounting for 1-2% of all forms of extra-pulmonary tuberculosis. Knowledge of the dermoscopy characteristics of different clinical types of cutaneous tuberculosis can help timely diagnosis resulting in better outcomes.


Materials and methods: All clinically suspected and biopsy confirmed cases of cutaneous tuberculosis seen from July 2019 through December 2021 were retrospectively recruited. Information including age, gender, disease duration, site and morphology of lesions, and presence of concomitant tuberculosis elsewhere was noted. Two investigators retrospectively reviewed the dermoscopic characteristics of these cases.


Results: Twenty-two patients comprised of 12 women and ten men met the inclusion criteria. Lupus vulgaris was the commonest presentation of cutaneous tuberculosis seen in 13 patients. Five had scrofuloderma, two had tuberculosis verrucosa cutis and one patient each had lichen scrofulosorum and papulo-necrotic tuberculid. Yellow-orange structureless areas (100%), linear/dot vessels (100%), white scales (92.3%), and white structureless areas (84.6%) were the predominant dermoscopy findings in lupus vulgaris. In scrofuloderma, linear vessels and white structureless areas were visible in all cases. Dirty white scales with a papillated surface were characteristically seen in tuberculosis verrucosa cutis, with one of the two patients each showing vessels and yellow-orange structureless areas. White globules with surrounding erythema were seen in lichen scrofulosorum and yellow-orange structureless areas with keratin plugs in papulo-necrotic tuberculid.


Conclusion: A thorough understanding of the characteristic dermoscopy of cutaneous tuberculosis can help suspect the diagnosis early resulting in better management opportunity.

Keywords : Dermoscopy, cutaneous tuberculosis, lupus vulgaris, scrofuloderma

References

1. Brito AC, Oliveira CMM, Unger DA, Bittencourt MJS. Cutaneous tuberculosis: epidemiological, clinical, diagnostic and therapeutic update. An Bras Dermatol. 2022 Jan 4:S0365-0596(21)00301-9. 2. Supekar BB, Wankhade VH, Singh RP, Ghanate TD, Bhat D. Clinical spectrum of cutaneous tuberculosis in Central India: A retrospective study. Indian Dermatol Online J 2021;12:826-33. 3. Errichetti E, Ankad BS, Jha AK, et al. International Dermoscopy Society criteria for non-neoplastic dermatoses (general dermatology): validation for skin of color through a Delphi expert consensus. Int J Dermatol. 2021 Jul 2. doi: 10.1111/ijd.15729. Epub ahead of print. 4. Ankad BS, Adya KA, Gaikwad SS, Inamadar AC, Manjula R. Lupus Vulgaris in Darker Skin: Dermoscopic and Histopathologic Incongruity. Indian Dermatol Online J. 2020 Nov 8;11(6):948-952. 5. Errichetti E, Stinco G. Dermatoscopy of Granulomatous Disorders. Dermatol Clin. 2018 Oct;36(4):369-375. 6. Chauhan P, Adya KA. Dermatoscopy of Cutaneous Granulomatous Disorders. Indian Dermatol Online J. 2021 Jan 16;12(1):34-44. 7. Brasiello M, Zalaudek I, Ferrara G, et al. Lupus vulgaris: a new look at an old symptom--the lupoma observed with dermoscopy. Dermatology. 2009;218(2):172-4. 8. Dermoscopy in general dermatology (non-neoplastic dermatoses) of skin of colour: a comparative retrospective study by the International Dermoscopy Society. Eur J Dermatol 2020; 30(6): 688-98 9. Jakhar D, Gupta RK, Sarin N. Dermoscopy of Tuberculosis Verrucosa Cutis. Indian Dermatol Online J. 2020 Sep 28;12(1):206-207. 10. Garg T, Kumar P, Das S, Singh S, Madan S. Lichen Scrofulosorum Coexisting with Phlyctenular Keratoconjuctivitis: Dermoscopy and Ocular Findings. Indian Dermatol Online J. 2021 Jun 20;12(6):941-943. 11. Jassi R, Yadav A, Chander R. Dermoscopy of Lichen Scrofulosorum. Indian Dermatol Online J. 2020 Jan 24;11(5):876-877.

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