Cutaneous tuberculosis in Southern Tunisia: clinical and therapeutic particularities

Abstract

Introduction: Tuberculosis remains a global health burden. Among all sites, cutaneous tuberculosis represents an uncommon manifestation with myriad presentations which explains the high rate of misdiagnosis. We aimed to study the epidemiological, clinical, and therapeutic features of cutaneous tuberculosis in southern Tunisia. Methods: A retrospective study including all patients diagnosed with extrapulmonary tuberculosis was conducted in the south of Tunisia between 1998 and 2019. This study specified the particularities of cutaneous tuberculosis cases over a 22-year period. Results: We encountered 1663 cases of extrapulmonary tuberculosis, among whom 56 cases were cutaneous tuberculosis (3.3%). Thirty eight (38) were women (67.9%). The mean age was 43±20 years. Multifocal tuberculosis was noted in 12 cases (21.4%). Systemic symptoms of tuberculosis represented by asthenia (55.3%), fever (42.8%) and weight loss (37.5%) were noted. Elevated C-reactive protein levels (50%) and accelerated erythrocyte sedimentation rates (42.8%) were also noted. The diagnosis was confirmed histologically (80.4%) and microbiologically (12.5%) . The median duration of antitubercular therapy was 11(9-14) months for multifocal tuberculosis cases (12 cases) and 8(6-12) months for cutaneous tuberculosis cases without any other sites of tuberculosis (44 cases). Adverse effects were noted in 14 cases (25%). The disease evolution was favorable in 54 cases (96.4%). Two patients had a relapse (3.6%). Conclusions: Cutaneous tuberculosis remains a common disease in south Tunisia. Patients should be screened for cutaneous tuberculosis starting with a general skin examination. Skin biopsy, the cornerstone of the diagnosis should be performed on any suspected cutaneous lesion.

Keywords

• cutaneous tuberculosis, tunisia, mycobacterium, antitubercular