Cutaneous tuberculosis and HIV infection at a referral centre in Rio de Janeiro, Brazil

Mann, Danielle; Sant’Anna, Flávia Marinho; Schmaltz, Carolina Arana Stanis; Freitas, Dayvison Francis Saraiva; Rolla, Valéria Cavalcanti; Cavalcante, Solange; Gutierrez-Galhardo, Maria Clara

doi:10.1590/0074-02760180184

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…This study describes 75 patients with CTB followed at a reference hospital for TB in the city of Rio de Janeiro, Brazil, for a period of 17 years. Case reports of 15 of these patients have already been published because of their particular characteristics, but they were maintained in the cohort …”

Section: Introductionmentioning

confidence: 99%

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Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

et al. 2019

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Background Brazil is one of the highest tuberculosis (TB) burden countries of the world. Cutaneous tuberculosis (CTB) is a rare form of extrapulmonary manifestation of tuberculosis. This study aimed to describe the clinico‐evolutive, laboratory and therapeutic aspects of CTB cases among patients from a cohort with TB in Rio de Janeiro, Brazil. Methods Cases of diagnosed CTB with microbiologic confirmation or clinical response to anti‐tuberculous treatment associated with positive smear or histopathological findings between the years 2000 and 2016 were selected. Results Seventy‐five patients with CTB were included, most were women (58.7%) with a median age of 42 years. CTB diagnosis was based on culture in only 42.7% of the cases. Scrofuloderma represented 50.7% of the cases, followed by erythema induratum of Bazin (EIB) (18.7%), tuberculous gumma (13.3%), lupus vulgaris (8%), TB verrucosa cutis (4%), orificial TB (2.7%) and associated forms (2.7%). Other TB presentations were pulmonary (22.7%), mammary (6.6%) and osteoarticular (4%). All patients who completed the treatment (97.3%) had their lesions healed. Only two patients (2.6%) needed to change the therapy due to adverse reactions. Fifty percent of EIB patients presented recurrence. Conclusions These data highlight the diversity of CTB presentations and the importance of the skin to assist in early identification and treatment of TB. More studies are necessary to improve the knowledge on EIB for a better approach towards these patients, mainly in cases of recurrence.

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Section: Introductionmentioning

confidence: 99%

“…Case reports of 15 of these patients have already been published because of their particular characteristics, but they were maintained in the cohort. 6…”

Section: Introductionmentioning

confidence: 99%

Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

et al. 2019

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“…Also, with the association of HIV infection the bacillary load may increase, and scrofuloderma being the predominant clinical form of CTB its association with HIV is not uncommon. 20 However, all our patients with scrofuloderma were negative for HIV infection.…”

Section: Discussionmentioning

confidence: 76%

Diagnostic Utility of Biplex/Multiplex Polymerase Chain Reaction in Infectious Granulomatous Dermatitis in North Indian Population

Parkhi

S²,

De³

et al. 2020

The American Journal of Dermatopathology

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Background: A definite diagnosis of infectious granulomatous dermatitis (IGD) is difficult for both practicing dermatologists and dermatopathologists due to overlapping clinical and histomorphological features. We aimed to explore the role of multiplex polymerase chain reaction (PCR) for identifying a definite etiological agent for diagnosis and appropriate treatment in IGD in formalinfixed paraffin-embedded tissue.Materials and Methods: Sixty-two cases of IGD were included, excluding leprosy. The histochemical stains including Ziehl-Neelsen, periodic acid-Schiff, and Giemsa were performed in all cases. A multiplex PCR was designed for detection of tuberculosis (TB) (IS6110 and mpt64), fungal infections (ITS1, ITS2; ZM1, and ZM3), and leishmaniasis (kDNA). The results of histomorphology, histochemical stains, and multiplex PCR were compared.Results: Among 62 cases, the sensitivity rate of PCR detection for organisms was 16.7%, 0%, 100%, 72%, 75%, and 66.7% in patients with TB, suggestive of TB, leishmaniasis, fungal infections, and granulomatous dermatitis not otherwise specified and granulomatous dermatitis suggestive of fungus, respectively. The TB PCR using IS6110 primers was negative in all cases; however, PCR using mpt64 primers was positive in 33.33% cases of scrofuloderma. The histochemical stains including Ziehl-Neelsen for acid-fast bacilli, periodic acid-Schiff for fungus, and Giemsa for Leishman-Donovan bodies showed positivity in 11.3%, 43.5%, and 3.2%, respectively. Conclusion:A multiplex PCR (Mycobacterium tuberculosis, Leishmania, and panfungal) is highly recommended in all cases of IGD where an etiological agent is difficult to establish by skin biopsy and histochemical stains along with a clinicopathological correlation. This will augment in appropriate treatment and will reduce empirical treatment and morbidity in such patients.

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“…TB and CTB are common manifestations of IRIS in patients who test positive for HIV and undergo antiretroviral therapy. 8 , 9 TB cases involving non-HIV IRIS have also been described recently. 10 In this patient, the discontinuation of MTX and tacrolimus after MTX-LPD onset may have caused non-HIV IRIS and the development of ulcerative tuberculous cellulitis.…”

Section: Discussionmentioning

confidence: 95%

A case of ulcerative tuberculous cellulitis in the setting of methotrexate-associated lymphoproliferative disorder

et al. 2022

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Cutaneous tuberculosis and HIV infection at a referral centre in Rio de Janeiro, Brazil

Cited by 9 publications

References 19 publications

Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

Cutaneous tuberculosis in Rio de Janeiro, Brazil: description of a series of 75 cases

Diagnostic Utility of Biplex/Multiplex Polymerase Chain Reaction in Infectious Granulomatous Dermatitis in North Indian Population

A case of ulcerative tuberculous cellulitis in the setting of methotrexate-associated lymphoproliferative disorder

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