Tuberculosis cutis verrucosa A18.44

Last updated on: 29.10.2020

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Synonym(s)

Light tuberculosis; Slaughterhouse tuberculosis; Slaughter tubercle; Tubercle Light tubercle; Tuberculosis verrucosa cutis; tuberculum anatomicum; verrucae necrogenicae; verruca necrogenica; warty tuberculosis of the skin; Wilk's disease

History
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Paltauf and Riehl, 1886

Definition
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Rare, post-primary superficial paucibacillary inoculation tuberculosis due to exogenous reinfection or autologous superinfection after the tuberculous primary complex with partial immunity and normergic reaction of the organism. Infection occurs when handling material containing the pathogen.

Notice! Occupational disease of the skin (farmers, butchers, anatomists, pathologists).

Etiopathogenesis
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Typical post-primary re-infection of the skin with good immunity. Penetration of tubercle bacteria into the skin through small injuries. Frequently occurring in people who work in agriculture.

Manifestation
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Butcher's tubercle: mainly farmers, butchers, veterinarians. Mostly type bovinus; extremely chronic course.

Mild tuberculosis: Doctors, employees in pathological or anatomical institutes. Mostly type humanus, often acute course with tuberculous lymphangitis.

Localization
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Especially the back of the hand or fingers as well as the foot or heel area are affected. Often unilateral manifestation.

Clinical features
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Mostly blurred, round, oval or polycyclic, indolent or slightly touch-sensitive, brown-red, coarse, coarse, sloppy papules or plaques, occasionally papulopustules or erosions with crustal formations. Lesions are often surrounded by an inflammatory halo. The lesions show peripheral progression and central scarring. Secondary infections and regional lymph node swelling are common.

Note: Since mycobacteria cannot penetrate intact skin, the manifestations of infection are typically found at the site of injury.

Histology
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Irregular acanthosis and papillomatosis in ortho- partly also parahyerpkeratosis. Pronounced nodular, sometimes also band-shaped infiltrate of the papillary or upper and middle dermis. Repeated epithelioid-cellular granulomas with central necrosis, abundant neutrophil granulocytes and nuclear debris as well as lymphocyte border of varying density.

Diagnosis
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S.u. Tuberculosis.

Differential diagnosis
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Internal therapy
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Operative therapie
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If necessary complete excision of small flocks

Progression/forecast
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Favorable with adequate therapy. S.u. Tuberculosis cutis luposa.

Literature
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  1. Barbagallo J et al (2002) Cutaneous tuberculosis: diagnosis and treatment. Am J Clin Dermatol 3: 319-328
  2. Chen Q et al (2019) Cutaneous tuberculosis: A great imitator. Clin Dermatol 37:192-199.
  3. Koch R (1890) Further news about a cure for tuberculosis. German med Wschr 16: 1029-1032
  4. Riehl G, Paltauf R (1886) Tuberculosis verrucosa cutis. Eline form of skin tuberculosis not yet described. Vjschr Derm Syph 13: 19-49
  5. Vora RV et al (2016) Tuberculosis verrucosa cutis with multifocal involvement. Indian Dermatol Online J 7:60-62.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020