External markers of tuberculosis

1. EXTERNAL MARKERS OF TB
LUPUS VULGARIS

REDDISH – BROWN JELLY LIKE NODULES ( APPLE - JELLY NODULES) SEEN
TYPICALLY OVER NOSE.
ALSO SEEN OVER HEAD , NECK ,LIMBS , TRUNK , GLUTEAL AREA & PENIS.
SCROFULODERMA
(Tuberculosis cutis colliquativa )


FIRM , PAINLESS , SKIN NODULES THAT ULCERATE .
OCCURS AS DIRECT EXTENSION OF TB INFECTION OF LYMPH NODES, BONES & JOINTS .
PHLYCTENULOSIS
2 TYPES - CORNEAL & CONJUCTIVAL
CONJUCTIVAL PHLYCTEN - 1-2 mm YELLOWISH , NODULE WITH SURROUNDING
HYPEREMIA SEEN NEAR THE INFERIOR LIMBUS
CORNEAL PHLYCTEN - MAY EXTEND INTO CORNEA AS GREY – WHITE SUPERFICIAL
ULCER
TINEA VERSICOLOR

OVAL SCALY MACULES/ PAPULES & PATCHES
CONCENTRATED ON CHEST, SHOULDERS & BACK (SHAWL LIKE DISTRIBUTION).
CAUSED BY NORMAL INHABITANT OF SKIN, MALASSEZIA FURFUR .
SCROFULA

PAINLESS CERVICAL TUBERCULOUS LYMPHADENOPATHY .
POSTERIOR & SUPRACLAVICULAR NODES INVOLVED COMMONLY.

ERYTHEMA NODUSUM
It is a t IS TYPE III HYPERSENSITIVITY REACTION
TENDER, SMOOTH, SHINY, RED NODULES OF 1 – 1O cm ; SEEN ON SHIN COMMONLY
ALSO OCCUR UNDER SKIN (THIGHS, ARM, TRUNK, FACE & NECK)
TUBERCULOUS VERRUCOSA
CUTIS

WARTY,SOLITARY PLAQUE WITH CENTARL INVOLUTION & ATROPIC SCAR
SEEN ON HANDS IN ADULTS & IN LOWER EXTREMITIES IN CHILDREN
OCCUR DUE TO DIRECT INOCULATION OF TB OVER SKIN

LICHEN
SCROFULOSORUM
GROUPED, PERIFOLLICULAR, LICHENOID PAPULES OF 1 –2 mm .
SEEN OVER TRUNK.

PAPULONECROTIC
TUBERCULID

NECROTIZING SKIN PAPULE S, OCCUR IN CLUSTERS.
APPEAR ON EXTERIOR ASPECTS OF EXTRIMITIES ( KNEE ,ELBOW ,BUTTOCK ,LOWER
TRUNK ) IN A SYMMETRICAL DISTRIBUTION .

REFERENCESS : COMPREHENSIVE TEXTBOOK OF TB , HARRISON ( 17 th EDITION ) Dr. Bhuvaneshwari , 2
nd
year PG [email protected]