Cutaneous tuberculosis (CTB) represents only 1%–2% of extrapulmonary forms of tuberculosis (TB). CTB can present in the isolation or coexist with pulmonary and disseminated forms of TB. Pathologically confirmed lupus vulgaris (LV) coexisting with lichen scrofulosorum with disseminated TB is presented and discussed. A 12-year-old boy presented with 2 years history of slowly progressive facial plaque and multiple skin colored papules on the neck. Tuberculin skin test was positive with a reading of > 20 mm. Histopathology revealed ulcerated areas with impetiginisation and keratopurulent debris. The entire skin showed pseudoepitheliomatous hyperplasia with numerous granulomas in the superficial dermis consisting of Langhans-type multinucleated macrophages. Lesions responded to anti-tuberculosis therapy (ATT) with residual facial scar. LV and lichen scrofulosurum are two forms of CTB which rarely occurs together. This case is being presented to highlight the occurrence of this rare presentation and the need to institute ATT to prevent scarring.
Background:
The aim of this study was to educate secondary school students on etiology, risk factors, clinical features, treatment, and prevention of scabies; to evaluate their knowledge base on scabies before and after an educational intervention; and to reassess this knowledge base and behavioral change, 6 months after, on a second visit.
Methods:
Questionnaires with standard questions on scabies, graded to a maximum score of 10, were administered to students in junior secondary Classes 1 and 2 across 4 states in Nigeria. Information obtained included subjects' demographics, scabies symptomatology, risks, and preventive behaviors. Students with active scabies were diagnosed and treated. Data were analyzed with STATA.
Results:
The mean test scores for the pretest and posttest at first visit were 2.82 ± 1.38 and 6.30 ± 1.09, respectively. This difference was statistically significant at
t
= 3.95,
P
= 0.004. Six months later, when the same schools were re-visited, the mean test scores for the pretest and posttest were 4.63 ± 0.54 and 5.87 ± 0.25, respectively. This difference was also significant at
t
= 4.13,
P
= 0.003. The prevalence of scabies was 3.5% at first visit and 4.34% at second visit;
t
= 0.24,
P
= 0.41.
Conclusions:
Secondary school students lack basic education on scabies and exhibit high-risk behaviors for scabies transmission. Knowledge on scabies needs constant reinforcement.
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