TUBERCULOSIS OF

THE SKIN.
 Def : chronic infection disease of Mycobacterium
tuberculous extra pulmonary → skin
 Clasification :
- Exogenous inf : Primary inoculation TB (PIT)
Tuberculosis verrucosa cutis
- Endogenous Spread:
Schrofuloderma(SD)
Lupus Vulgaris(LV)
Acut miliary TB (AMT)
PIT
- Def : inoculation M TB percutaneous, occurs at
inoculated site in nonimmune host
- Clinical feature :
- papule➜2-4w after wound healing
↓enlarges
painless ulcer
↓
thick crust
DD: primary syphilis with chancre, sporotrichosis
 Tuberculosis Verrucosa Cutis
- Def : percutaneous inoculation, occurs at
inoculated site in individual with prior TB inf
- Clinical feature:

papule with violaceus halo

↓
hyperkeratotic, irregular border, verucous
plaque, purpelish, red or brown colour
Location: hands, knees, ankle, buttocks
DD: Veruca Vulgaris, pyoderma,
blastomycosis, squamous cell carcinoma
 Acute Miliary TB
Def : lesion that appear cause of the
spreading of body focus. Reaction of
tuberculin test is negative
Clinical features :
profuse crop of bluish papules,
vesicles, pustules or haemoragic lesins
↓
small ulcers
Schrofuloderma
- Def : results from the involvement and
breakdown of the skin overlying a TB fokus,
ussually a lymph glands (cervical, axilla, inguinal,
retroauricular)
- Clinical feature :
bluish-red nodule (mobile) overlying the infected
gland, tender in palpation
↓
undermined ulcers
↓ fistula
intercommunicate beneath rigdes
↓
scar
DD: Hidradenitis suppurativa, sporotrikosis, acne
conglobata
 Schrofuloderma, merupakan
akibat dari kikut terkenanya kulit
yang menutupi suatu fokus
tuberkulosis biasanya nodus
limfe, dimana yang paling sering
adalah di leher
 Gambaran klinis
berupa fistula multipel dan
jaringan parut yang padat
 Lupus Vulgaris
- Def : a progressive form of cutanedus TB
occuring in a person with a moderat or high
degree of immunity
- Clinical feature :
*generaly confluence nodules erytem
becomes yellowish and look like apple-jelly with
diascopy
- plaque form: plaque eritem with scale like
psoriasis appearance, edge becomes
thickened and hyperkeratotic
DD: sarcoidosis, chronic cutaneous lupus
erythematosus, leprosy, pyoderma
 Lupus vulgaris terdapat di kepala dan leher
 Gambaran khas adalah bercak noduler
berwarna coklat kemerahan
 Lupus vulgaris merupakan proses destruktif
dan pada tulang rawan hidung dan telinga
bisa terjadi kerusakan hebat
 Tes MT (Mantoux Test) positif kuat
 Teraphy :
- Isoniazid 300mg/d → 6 m
- Rifampicin 450mg/d ≤ 50kg BW,
600mg/d > 50kg BW
- Pyrazinamide 1,5 gr/d 50-74 kg BW, 2,5
gr/d >75 kg BW → 2 m (I)
- Ethambutol 15mg/kg BW/d → 2 m (I)
 TERIMA KASIH
BY : Dr. AHMAD GARLI,SpKK.