Tuberculosis cutis miliaris disseminata

Cutaneous miliary tuberculosis.

Miliar tuberculosis of the skin due to haematogenous seeding. This occurs mainly in immunosuppressed patients or children or old people.

In particular, infants, young children, the elderly and immunocompromised people are affected.

• After haematogenous seeding of tubercle bacilli, miliary tuberculosis occurs.
• Abundant pathogens are found in the cutaneous lesions.

• Partially ulcerating, densely standing erythematous-brownish, haemorrhagic papules.
• Enoral involvement is possible.

• Travel history.
• Clinical.
• Tuberculin test (Mendel-Mantoux) often negative.
• Quantiferone test.
• Biopsy.

To exclude systemic involvement:

• Thoracic X-ray or CT- thorax.
• Sonography of the abdomen and kidneys.
• In the morning (fasting up to 4h) on 3 consecutive days, sputum must be collected.
• Pass urine in the morning on 3 consecutive days (fluid restriction the evening before!).
• Bronchoalveolar lavage (BAL).

Most often, disseminated organ infestation occurs.

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