A study of cutaneous tuberculosis in children

Sixty-three children out of a total of 199 patients seen with cutaneous tub erculosis during a 7-year period were included in this study. Culture was p ositive in only four, and the diagnosis was based on clinical examination, tuberculin reaction, histopathology, and response to antitubercular therapy . Forty had lupus vulgaris (LV) and 23 scrofuloderma (SD). The lower half o f the body was predominantly affected in those with LV, and keratotic and h ypertrophic forms were frequently encountered. LV planus mainly affected th e face. Ulcerative and atrophic types of LV were infrequent. Extensive lesi ons in three children led to disfiguring scars and contractures. Scrofulode rma often involved the cervical group of lymph nodes followed by the inguin al, submandibular, and axillary groups. As compared to skin tuberculosis in adults, regional lymph node involvement in LV was more common, and a combi nation of both LV and SD was less frequent in children. No difference in cl inical presentation could be detected between the BCG vaccinated and unvacc inated children. Tuberculous infection either in the lungs or the bones was present in eight children. An HIV test done in five patients with widespre ad lesions was negative. Irregular therapy or late diagnosis leading to ser ious complications, inadequate parental or community support, and lack of a wareness among practitioners are the problems to be remedied.