| Tuberculosis verrucosa cutis | |
|---|---|
| Other names | Lupus verrucosus,[1] prosector's wart,[1] warty tuberculosis[1] anatomist's wart, verruca necrogenica |
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| Specialty | Infectious disease |
Tuberculosis verrucosa cutis is arash of small, redpapules andnodules in theskin that may appear two to four weeks after inoculation byMycobacterium tuberculosis in a previously infected and immunocompetent individual.[citation needed]
It is also known as "prosector's wart" because it was a commonoccupational disease ofprosectors, the preparers ofdissections andautopsies. Reinfection bytuberculosis via the skin, therefore, can result from accidental exposure to human tuberculous tissue inphysicians,pathologists and laboratory workers; or to tissues of other infected animals, inveterinarians,butchers, etc.
TVC is one of the many forms of cutaneoustuberculosis, such as thetuberculous chancre (which results from the cutaneous inoculation inimmunocompetent people without previous exposure), and thereactivation cutaneous tuberculosis (the most common form, which appears in previously infected patients). Other forms ofcutaneous tuberculosis are:lupus vulgaris,scrofuloderma,lichen scrofulosorum,erythema induratum and thepapulonecrotic tuberculid.
It was described byRené Laennec in 1826.[2]
Because the TVC's entry point usually is the site of atrauma,wound or puncture in the skin (during an autopsy, for example), the most frequent site for the wart are thehands. But it can occur anywhere in the skin, such as in the sole of the feet, in theanus, and, in the case of children fromdeveloping countries, in thebuttocks andknees. This is because children from countries of high incidence of tuberculosis can contract the lesion after contact with tuberculoussputum, by walking barefoot, sitting or playing on the ground.[citation needed]
When recent, the skin lesion has the outside appearance of awart or verruca, thus it can be confused with other kinds of warts. It evolves to an annular red-brown plaque with time, with central healing and gradual expansion in the periphery. In this phase, it can be confused withfungal infections such asblastomycosis andchromoblastomycosis.[citation needed]
Thediagnosis is confirmed by a skinbiopsy and a positive culture foracid-fast bacilli. APPD test may also result positive.[citation needed]
Therapy for cutaneous tuberculosis is the same as for systemic tuberculosis, and usually consists of a 4-drug regimen, i.e.,isoniazid,rifampin,pyrazinamide, andethambutol orstreptomycin.[citation needed]
Goldman, G.; Bolognia, J.L.Pinpointing cutaneous signs of tuberculosis: is it a common wart, or tuberculosis verrucosa cutis?Archived 2004-11-16 at theWayback MachineJournal of Critical Illness, Dec. 2002.
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