Cutaneous Manifestations of Tuberculosis: A Prospective Observational Study from a Tertiary Care Centre

Abstract

Introduction: Cutaneous tuberculosis (CTB) represents an uncommon manifestation of extrapulmonary tuberculosis, particularly in endemic regions. Its diverse clinical presentations and paucibacillary nature often pose diagnostic challenges, leading to delays in recognition and treatment.

Objectives: To evaluate the clinical spectrum, histopathological characteristics, and therapeutic response of cutaneous manifestations of tuberculosis in patients attending a tertiary care centre..

Methods:A prospective observational study was conducted in the Department of Dermatology at a tertiary care hospital over a three-month period. Forty adult patients with confirmed pulmonary or extrapulmonary tuberculosis presenting with cutaneous lesions suggestive of CTB were included. Detailed demographic and clinical data were recorded. Skin biopsies were performed for histopathological evaluation, and microbiological investigations including Ziehl–Neelsen staining were undertaken where indicated. All patients received standard anti-tubercular therapy, and treatment response was assessed during follow-up..

Results: The majority of patients were in the 31–60-year age group, with a male predominance (26/40, 65%). Lupus vulgaris was the most common clinical variant (12/40, 30%), followed by scrofuloderma (9/40, 22.5%) and tuberculids (7/40, 17.5%). Lesions most frequently involved the face (14/40, 35%) and neck (8/40, 20%). Histopathological examination revealed granulomatous inflammation in all cases, with caseating granulomas observed in 32 patients (80%). Acid-fast bacilli positivity was demonstrated in 28 patients (70%). Following initiation of anti-tubercular therapy, complete clinical improvement was noted in 28 patients (70%), while 9 patients (22.5%) showed partial response.

Conclusions: Cutaneous tuberculosis demonstrates varied clinical morphology and should be considered in patients presenting with chronic dermatological lesions in tuberculosis-endemic settings. Clinicopathological correlation facilitates early diagnosis, and timely initiation of anti-tubercular therapy results in favorable therapeutic outcomes.