Cutaneous tuberculosis
Last Updated: 2021-07-25
ICD11: 1B12.8
Last Updated: 2021-07-25
Author(s): Anzengruber F.
ICD11: 1B12.8
Robert Koch 1882 (Tuberculosis in general)
Skin tuberculosis, scruphuloderm, lupus vulgaris, Koch's disease
Group of skin conditions that are defined as reaction to tuberculosis-derived antigens and/or direct pathology induced by tuberculosis bacteria.
Rare in industrialized countries, however in poorer countries, up to 30% of all persons have latent tuberculosis and of these, every fifth develops active disease.
M. tuberculosis accounts for >99% of all cases, M. bovis and M. africanum for the rest. Atypical mycobacteriosis such as in immunosuppression are counted separately.
Skin tuberculosis in anergy:
Anergy means the intradermal tuberculin test is negative. The lack of cellular defence against M. tuberculosis can be caused by several circumstances. A lack of contact with M. tuberculosis as well as a weakened immune defence can be decisive for the negative tuberculin test.
Skin tuberculosis in normergy:
There is a tuberculosis-specific immune reactivity. These are postprimary forms of tuberculosis (patients have already had a primary tuberous complex). Typicall few pathogens, tuberculous granulomas and a positive tuberculin test.
Skin tuberculosis in hyperergy:
If the tuberculin reaction is exceptionally intense, it is called hyperergy. In most cases, the tuberculin reactions do not have to be particularly high.
See the various conditions. Very broad differential diagnosis.
Can occur anywhere, head and neck region most common.
Very good when treatment is initiated, except for irreversible residual pathology such as scarring.
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