Tuberculids
Last Updated: 2019-08-26
ICD11: -
Last Updated: 2019-08-26
Author(s): Anzengruber F., Navarini A.
ICD11: -
Darier 1896.
Id reaction of the skin during a hyperergic phase of a tuberculosis infection.
A distinction is currently being made:
Papulonecrotic tuberculide.
Tuberculosis cutis lichenoides.
Erythema induratum. Depending on the disease.
Depending on the disease.
Important for the diagnosis position are that...
...organ tuberculosis.
... a clinical substrate is present.
... a distinctly positive tuberculin test was made.
... the symptoms subside after antitubercular therapy.
Therapy regimen:
The initial phase should last 8 weeks/2 months. During this time, the majority of bacteria are killed. In the following therapy phase (which lasts for months) the remaining bacteria are eliminated. The anti-tubercular therapy should be continued for at least 2 months after the skin is free of symptoms.
The therapy should last individually between 12-24, but at least 6 months!
Induction phase (2 months):
Rifampicin p.o. 10 mg/kg bw/ d
Isoniazid p.o. 5 mg/kg bw. (with Vit B 6)
Pyrazinamide p.o. 35 mg/ bw/ d possibly in combination with Allopurinol!
Ethambutol p.o. 15 mg/kg bw/ d
A clear improvement can be seen in the vast majority of cases after 1 ½ months.
- Consolidation phase:
Induction phase (2 months):
Rifampicin p.o. 10 mg/kg bw/ d
Isoniazid p.o. 5 mg/kg bw. (with Vit B 6)
Ethambutol p.o. 15 mg/kg bw/ d (may also be omitted if isoniazide resistance is excluded)
HIV Patient: Therapy must take place at ≥ for 7 months. Ethambutol should be replaced by streptomycin p.o. 15-20 mg/kg bw/ d (from > 60 J. max 750 mg) for additional therapy with NNRTI.Tuberculid in a child: transformation from papulonecrotic to lichen scrofulosorum. Pediatric Dermatology 2003;20:91-3.
Aires NB, Santi CG , Nico MMS. Tuberculid of the Glans Penis. Acta Derm Venereol 2006;86:552-3.
Degitz K, Steidl M, Thomas P, Plewig G , Volkenandt M. Aetiology of tuberculids. The Lancet 1993;341:239-40.
Garb J. Tuberculosis cutis colliquativa (tuberculous gummas) healed rapidly with local application of promin jelly; report of a case. Arch Derm Syphilol 1948;58:308-13.
Jordaan HF, Van Niekerk DJT , Louw M. Papulonecrotic Tuberculid. The American Journal of Dermatopathology 1994;16:474-85.
1. Tuberculid in a child: transformation from papulonecrotic to lichen scrofulosorum. Pediatric Dermatology 2003;20:91-3.
Aires NB, Santi CG , Nico MMS. Tuberculid of the Glans Penis. Acta Derm Venereol 2006;86:552-3.
2. Degitz K, Steidl M, Thomas P, Plewig G , Volkenandt M. Aetiology of tuberculids. The Lancet 1993;341:239-40.
3.Garb J. Tuberculosis cutis colliquativa (tuberculous gummas) healed rapidly with local application of promin jelly; report of a case. Arch Derm Syphilol 1948;58:308-13.
Jordaan HF, Van Niekerk DJT , Louw M. Papulonecrotic Tuberculid. The American Journal of Dermatopathology 1994;16:474-85.
Share your experience and shape the future with us!
Do you have 5 minutes to take our short survey?
Together with you we would like to further develop DermaCompass.
There is the chance to win one of 3x50 EUR Amazon vouchers.
Be part of our innovation process!
Share your experience