A CLINICO-PATHOLOGICAL STUDY OF CUTANEOUS TUBERCULOSIS IN HIV POSITIVE PATIENTS

Ajay Chopra, Reetu Agarwal, Krishna Talukdar, Barnali Mitra, Loknandini Sharma, Debdeep Mitra

Abstract


Background: Cutaneous tuberculosis is a type of extra pulmonary tuberculosis. Although rare than its pulmonary counterpart, it in most cases is the initial diagnostic marker of this systemic infection. HIV infection predisposes a person to tuberculosis infection and reactivation of latent tuberculosis.
Aims: The study is aimed to find out the incidence, histo-pathological features and clinical spectrum of cutaneous tuberculosis in HIV positive patients.
Materials and Methods: A total of 15 cases of newly diagnosed patients of cutaneous tuberculosis attending dermatology out patient department of a tertiary care hospital in over a period of 1 year were included in the study. A through clinical examination and investigations including histopathological examination was carried out. Investigations were targeted towards finding a pulmonary or primary source of tuberculoisis.
Results: Scrofuloderma was the most common form of cutaneous tuberculosis seen in HIV positive patients, reported in 33% cases followed by Tuberculosis verrucosa cutis in 26%, papulonecrotic tuberculids in 13%, lupus vulgaris, military tuberculosis and lichen scrofulosorum, in 7% cases. The Mantoux test was positive in 83.33% cases. Characteristic tuberculoid granulomas were seen in 72.22% cases of lupus vulgaris, 42.86% cases of scrofuloderma and all cases of tuberculosis verrucosa cutis and lichen scrofulosorum.
Conclusion: Cutaneous tuberculosis in its various forms is still prevalent and awareness and a high level of clinical suspicion and histopathological confirmation is the key to early diagnosis and successful management of these cases.


Keywords


Tuberculosis, Clinicopathological study, HIV, HIV patients, Scrofuloderma, Cutaneous tuberculosis.

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