Cutaneous tuberculosis:: a 15-year descriptive study

INTRODUCTION. Cutaneous tuberculosis has experienced a resurgence following a period of decline. The aim of this study was to determine the clinical and epidemiological characteristics of cutaneous tuberculosis in the Ferrol Healthcare Area (Spain). METHODS. Between 1991-2005,1139 new cases of tuberculosis were diagnosed in Ferrol and submitted to a descriptive analysis. Cutaneous involvement was investigated in all cases. RESULTS. Among 1139 patients, 55 cases of cutaneous tuberculosis were diagnosed (4.8%). The condition was more frequent in women (70.9%), average age was 44.1 +/- 23.3 years, and 56.4% of patients were treated with 6HR2Z-E. Among the 55 cases, 26 (2.3%) were true cutaneous tuberculosis and 29 (2.5%) were tuberculids. In the 26 cases of true tuberculosis, the most frequent form was scrofuloderma (32.7%), followed of lupus vulgaris (7.2%), tuberculous gumma (3.6%), and tuberculosis verrucosa cutis (3.6%). The most frequent locations were the neck, face and trunk, and in 76.9% other sites were involved (lymph nodes 14, bone 6, lung 4, and intestine 1). In the 29 cases with tuberculids, erythema nodosum was the most frequent form (49.1 %) followed by erythema induraturn of Bazin (3.6%). The lower extremities were affected in all cases and there was simultaneous involvement of other site in 51.9%. In patients with true cutaneous tuberculosis, the diagnostic yield was greater (necrotizing granulomas in 70.6% of biopsies and positive Lowenstein culture for Mycobacterium tuberculosis in 77.8%) and average age was higher than in patients with tuberculids (P <.05). CONCLUSION. Cutaneous tuberculosis is uncommon, preferentially affects women, and is usually associated with tuberculous disease in other locations, particularly in the case of scrofuloderma.