Review Article

Cutaneous Tuberculosis: Clinicopathologic Arrays and Diagnostic Challenges

Table 1

Clinical manifestations of cutaneous tuberculosis and its differential diagnosis.

S. N Classification of cutaneous tuberculosisDiagnostic considerations

1Exogenous cutaneous TuberculosisTuberculosis chancresporotrichosis, leishmaniasis, atypical mycobacteriosis, syphilis, cat scratch disease and tularemia
Tuberculosis verrucosa cutisparacoccidioidomycosis, leishmaniasis, sporotrichosis, tuberculosis verrucosa and chromomycosis. Lobomycosis, atypical mycobacteriosis, hypertrophic lichen planus, verrucous carcinoma, iododerma, bromoderma, verruca vulgaris, keratoacanthoma centrifugum and pyoderma vegetans

2Endogenous cutaneous tuberculosisScrofulodermatertiary syphilis, paracoccidioidomycosis, actinomycoses, lymphogranuloma venereum, bacterial abscesses, tumor metastasis, histiocytosis and hidradenitis
Orificial tuberculosisbullous diseases, trauma, fungal diseases, syphilis, sarcoidosis, or squamous cell carcinoma
Lupus vulgarisbasal cell carcinoma, sarcoidosis, discoid lupus erythematosus, Leprosy, Deep Fungal infections
Tuberculous gummaleishmania, sporotrichosis, nocardiosis, atypical mycobacteria (Mycobacterium marinum), pyogenic infections (Staphylococcus aureus, Streptococcus), and deep fungal infections
Acute miliary tuberculosismetastatic carcinomas

3TuberculidsPapulonecrotic tuberculidpityriasis lichenoides et varioliformis acuta (PLEVA), leukocytoclastic necrotizing vasculitis, pruritus and secondary syphilis
Lichen scrofulosorumlichen planus and lichen nitidus, syphilid lichenoides, eczematid, keratosis pilaris, pityriasis rubra pilaris (PRP) and micropapular sarcoidosis
Erythema induratum of Bazinerythema nodosum, cutaneous polyarteritis, pancreatic panniculitis, lupus profundus, subcutaneous sarcoidosis and cutaneous T-cell lymphoma