CUTANEOUS TUBERCULOSIS

By Gary M. White, MD


Several variants of tuberculous infection occur corresponding to the immunity of the individual.

High Immunity

Lupus Vulgaris

Tuberculosis Verrucosa Cutis

Intermediate Immunity

Oroficial type with periorificial ulcerations

Low Immunity

TB cutis miliaris disseminata

TUBERCULIDS

Tuberculosis may also be associated with tuberculids (no viable organsims in the skin). Tuberculids are probably caused by hematogenous spread of low numbers of bacilli or tubercular antigens in highly sensitive individuals. Any organisms that make it to the skin are either dead already or rapidly killed.

Erythema Induratum (Bazin's Disease)

Lichen Scrofulosorum Children or young adults with symptomatic red or red-brown papules.

Papulonecrotic Tuberculid Papulonecrotic lesions that heal with variolaform scars.

Lichenoid tuberculid eruptions.

Older individuals. PPD negative. Flat-topped, lichenoid lesions.

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