Asunto(s)
COVID-19 , Eritema Pernio , Eritema Pernio/epidemiología , Brotes de Enfermedades , Humanos , Pandemias , SARS-CoV-2Asunto(s)
Infecciones por Coronavirus/epidemiología , Control de Infecciones/organización & administración , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Enfermedades de la Piel/diagnóstico , Telemedicina , COVID-19 , Estudios de Cohortes , Infecciones por Coronavirus/prevención & control , Dermatología/métodos , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Derivación y Consulta/estadística & datos numéricos , Estudios RetrospectivosRESUMEN
Cutaneous tuberculosis with lymphatic spread is rarely described. We report the case of a woman aged 38, immunocompetent, working in a fruit sorting center, who consulted us for ulceration of the left third finger that had persisted for four months, following a prick from a prickly pear. Physical examination revealed a nodular, erythematous, and ulcerative lesion of the left third finger, associated with inflammatory subcutaneous nodules arranged in a line along the ipsilateral upper extremity and an ipsilateral axillary lymph node. Laboratory tests and chest X-ray were normal. Pathological examination revealed granulomatous chronic inflammation without necrosis. PCR detected DNA from Mycobacterium tuberculosis. No extracutaneous tuberculosis locations were detected. A tuberculous chancre by direct inoculation was therefore diagnosed. The patient received quadruple therapy (rifampicin + isoniazid + pyrazinamide + ethambutol) for 2 months, followed by a combination therapy based on isoniazid and rifampicin for 6 months. Marked regression of the cutaneous lesions occurred after 1 month of first-line therapy. A tuberculous chancre is a rare form of cutaneous tuberculosis, with possible lymphatic spread, in immunocompromised patients but also in immunocompetent children and young adults.