Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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POSTGRADUATE CLINICAL SECTION
Year : 2009  |  Volume : 4  |  Issue : 1  |  Page : 32-34
Skin lesions in a 30-year-old male having smear-positive pulmonary tuberculosis


1 Department of Tuberculosis and Respiratory Medicine, Postgraduate Institute of Medical Science, Rohtak, India
2 Department of Skin and VD, Postgraduate Institute of Medical Science, Rohtak, India
3 Department of Physiology, Postgraduate Institute of Medical Science, Rohtak, India

Date of Submission24-Jul-2008
Date of Acceptance20-Aug-2008

Correspondence Address:
Prem P Gupta
9J/17, Medical Enclave, PGIMS, Rohtak - 240 001
India
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DOI: 10.4103/1817-1737.44784

PMID: 19561921

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How to cite this article:
Gupta PP, Jain V K, Agarwal D, Yaseer P T. Skin lesions in a 30-year-old male having smear-positive pulmonary tuberculosis. Ann Thorac Med 2009;4:32-4

How to cite this URL:
Gupta PP, Jain V K, Agarwal D, Yaseer P T. Skin lesions in a 30-year-old male having smear-positive pulmonary tuberculosis. Ann Thorac Med [serial online] 2009 [cited 2020 Jan 22];4:32-4. Available from: http://www.thoracicmedicine.org/text.asp?2009/4/1/32/44784


A 30-year-old male, farm worker, chronic smoker presented at our institute with low-grade intermittent fever, cough with expectoration and asymptomatic, painless, dusky red skin lesions varying from the size of a peanut (3--4 mm) to a coin (up to 3--4 cm) over the upper trunk (back), neck and bilateral extensor surface of the upper limbs [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5]. He had smear-positive pulmonary tuberculosis diagnosed in January 2006. He was given rifampicin, isoniazid, pyrazinamide and ethambutol for 2 months, by the end of which his sputum converted to negative, at which stage he was continued with rifampicin and isoniazid for a further 4 months. All drugs were supervised and administered thrice a week. After that, he remained symptom free for 2 years. At present, he is having an average build and good nutrition, with stable vital signs. There was no clubbing, cyanosis, ictenus or pallor. There was no enlargement of any group of lymph nodes. The liver was not palpable and the examination of other systems was not remarkable. The chest radiograph was suggestive of bilateral upper zone fibrocavitary disease, which was suggestive of tuberculosis. The sputum smear examination confirmed the presence of acid-fast bacilli. He was diagnosed as having smear-positive pulmonary tuberculosis and was started with WHO category II antitubercular treatment. A skin wedge biopsy was also taken.


   Clinical Questions Top


  1. What is the diagnosis of skin lesions?
  2. Can you guess the immune status of this patient?
  3. Is there any seasonal variation of this disease?
  4. Can you demonstrate mycobacteria in skin lesion?




Click here to view answer. View Answer


 
   References Top

1.Gupta PP, Agarwal D. Papulonecrotic tuberculid with concomitant pulmonary tuberculosis: A case report. Curr Med Trends 2006;10:1890-4.  Back to cited text no. 1    
2.Whitfield A. A case of unusual papulonecrotic tuberculid. Br J Dermatol 1913;25:168-70.  Back to cited text no. 2    
3.Quiros E, Bettinardi A, Quiros A, Piedrola G, Maroto MC. Detection of mycobacterial DNA in papulonecrotic tuberculid lesions by polymerase chain reaction. J Clin Lab Anal 2000;14:133-5.  Back to cited text no. 3    
4.Chong LY, Lo KK. Cutaneous tuberculosis in Hong Kong: A 10-year retrospective study. Int J Dermatol 1995;34:26-9.  Back to cited text no. 4  [PUBMED]  
5.Kumar B, Muralidhar S. Cutaneous tuberculosis: A twenty-year prospective study. Int J Tuberc Lung Dis 1999;3:494-500.   Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Chen SC, Tao HY, Tseng HH. Papulonecrotic tuberculid: A rare skin manifestation in a patient with pulmonary tuberculosis. J Formos Med Assoc 2000;99:857-9.  Back to cited text no. 6  [PUBMED]  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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