Patient Story

Disease : Chronic-Papulonectrotic Tuberculid

Last Updated on : 18 Aug 2019

Case Started on : 31 Dec 2018

Tuberculosis is a mycobacterial infection that most frequently occurs due to infection with Mycobacterium tuberculosis, an acid-fast bacillus. The high prevalence of tuberculosis worldwide (one-third of the world population), its transmissible nature, and the significant morbidity and mortality associated with this infection account for the status of tuberculosis as a major public health concern. In India, each year, approx. 220,000 deaths are reported due to Tuberculosis.
India bears a disproportionately large burden of the world's tuberculosis rates, as it continues to be the biggest health problem in India.

Papulonecrotic tuberculid is a chronic, recurrent, and symmetric eruption of necrotizing skin papules arising in crops, involving primarily the buttocks and extensor surfaces of the arms and legs. A hallmark of this condition is that lesions heal with varioliform and pitting scarring. Till date I have seen only 2-3 cases in my clinic, 2 at Balrampur and one at Lucknow.Tuberculous infection of the skin is rare, accounting for approximately 1-2% of all reported cases of tuberculosis. Histopathological studies of papulonecrotic tuberculid have shown a subacute or granulomatous vasculitis and dermal coagulative necrosis. The bacilli are almost always absent in skin biopsies, although PCR can be positive.
This boy has presented at My Lucknow clinic with skin eruptions of the face. This case has already been to KGMC and to a famous dermatologist of Lucknow. Deptt of Dermatology and VD has diagnosed it as Papulonecrotic tuberculid and they have sent skin biopsy sample to Mumbai. Unfortunately patient reported that they have lost the report. Father was worried as this child was suffering from recurrent outbreak since last 8 years. Anyhow his treatment has been started after a detailed case taking at clinic with the method of Medicine transmission through hair.

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