A Case of an 18-year-old Filipino Male with Tuberculosis Verrucosa Cutis

Authors: Athena Emmanuelle M. Parro, MD, Fatima Jacinto- Calimag, MD, Tricia Malongat, MD, FPDS, Elizabeth P. Prieto, MD, FPDS

Abstract

Introduction: Tuberculosis verrucosa cutis is one variant of cutaneous tuberculosis caused by exogenous inoculation of M. tuberculosis at sites of minor wounds or trauma. Lesions usually occur at the upper and lower extremities and buttocks. They initially present as a solitary small asymptomatic papule which slowly expands peripherally leading to hyperkeratotic verrucous plaque with an irregular border. Regional lymph nodes are rarely affected. TVC also does not present with an “apple jelly appearance” on diascopy.

Case Summary: This is a rare case of an 18-year-old Filipino male who presents with a 10-year history of a chronic, asymptomatic and gradually enlarging plaques on the right elbow. The patient had history of trauma on the right elbow prior to the appearance of the lesions. Skin punch biopsy revealed Tuberculosis Verrucosa Cutis. PPD test was positive which revealed greater than 10mm induration. On the other hand, Sputum Gene XPert revealed indeterminate results. Patient was enrolled to TB DOTS for 6 months treatment of antiKoch’s medications. The patient responded well, characterized with decrease in the size and thickness of plaques on the elbows.

Conclusion: Tuberculosis verrucosa cutis is a chronic condition that may present as an enlarging asymptomatic papules and plaques. Tuberculosis verrucosa cutis has good prognosis. The lesions respond to typical anti-tuberculosis medications and may detect improvement as early as early as 5 weeks into therapy. Marked improvement of the lesions can be expected by 10 weeks.

 

Citation

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Keywords

TVC, Tuberculosis verrucosa cutis, M. tuberculosis

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