Limits...
Cutaneous tuberculosis with nonreactive PPD skin test: a diagnostic challenge.

Nassif PW, Rosa AP, Gurgel AC, Campanerut PA, Fillus Neto J, Cardoso RF - An Bras Dermatol (2015 Jan-Feb)

Bottom Line: The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test.Diagnosis was made by tissue culture and PCR of skin biopsy material.The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

View Article: PubMed Central - PubMed

Affiliation: Faculdade Ingá (Uningá), Maringá, PR, Brazil.

ABSTRACT
The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test. Diagnosis was made by tissue culture and PCR of skin biopsy material. The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

Show MeSH

Related in: MedlinePlus

Ulcer with irregular borders and center with areas of necrosis and fibrin on thelateral side of the right leg
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4323713&req=5

f02: Ulcer with irregular borders and center with areas of necrosis and fibrin on thelateral side of the right leg

Mentions: A 63-year-old female patient had an indurated, infiltrated erythematous-ferruginousplaque with central atrophic scars (from previous biopsies) on her right leg (Figure 1). She had been treated with antibiotics,antifungal and corticosteroid therapy with no improvement. We repeated the biopsy andthe lesion progressed to a 6-cm ulcer with irregular borders and fibrino-necrotic areas(Figure 2). The following tests were normal:blood cell count, VDRL, ANA, AFB in the lymph nodes, HIV, culture for bacteria and fungi(in biopsy material), serology for leishmaniasis, and radiography of the chest and legs.ESR was 48 mm/hour and PPD was nonreactive. The anatomicopathological study showedhistiocytes and multinucleated giant cells (Figure3). Culture was positive for AFB. PCR (polymerase chain reaction) revealedgenotypic characters of Mycobacterium tuberculosis (primers TB1 (primers: TB1(5’-CCTGCGAGCGTAGGCGTCGG-3’) and TB2 (5’-CTCGTCCAGCGCCGCTTCGG-3’)), which amplify afragment of 123 base-pairs (bp) of the IS6110 sequence (Figure 4). The treatment was performed with pyrazinamide, rifampicin,isoniazid and ethambutol.


Cutaneous tuberculosis with nonreactive PPD skin test: a diagnostic challenge.

Nassif PW, Rosa AP, Gurgel AC, Campanerut PA, Fillus Neto J, Cardoso RF - An Bras Dermatol (2015 Jan-Feb)

Ulcer with irregular borders and center with areas of necrosis and fibrin on thelateral side of the right leg
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4323713&req=5

f02: Ulcer with irregular borders and center with areas of necrosis and fibrin on thelateral side of the right leg
Mentions: A 63-year-old female patient had an indurated, infiltrated erythematous-ferruginousplaque with central atrophic scars (from previous biopsies) on her right leg (Figure 1). She had been treated with antibiotics,antifungal and corticosteroid therapy with no improvement. We repeated the biopsy andthe lesion progressed to a 6-cm ulcer with irregular borders and fibrino-necrotic areas(Figure 2). The following tests were normal:blood cell count, VDRL, ANA, AFB in the lymph nodes, HIV, culture for bacteria and fungi(in biopsy material), serology for leishmaniasis, and radiography of the chest and legs.ESR was 48 mm/hour and PPD was nonreactive. The anatomicopathological study showedhistiocytes and multinucleated giant cells (Figure3). Culture was positive for AFB. PCR (polymerase chain reaction) revealedgenotypic characters of Mycobacterium tuberculosis (primers TB1 (primers: TB1(5’-CCTGCGAGCGTAGGCGTCGG-3’) and TB2 (5’-CTCGTCCAGCGCCGCTTCGG-3’)), which amplify afragment of 123 base-pairs (bp) of the IS6110 sequence (Figure 4). The treatment was performed with pyrazinamide, rifampicin,isoniazid and ethambutol.

Bottom Line: The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test.Diagnosis was made by tissue culture and PCR of skin biopsy material.The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

View Article: PubMed Central - PubMed

Affiliation: Faculdade Ingá (Uningá), Maringá, PR, Brazil.

ABSTRACT
The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test. Diagnosis was made by tissue culture and PCR of skin biopsy material. The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

Show MeSH
Related in: MedlinePlus