A Comparison Between Cutaneous Tuberculosis And Leprosy
Cutaneous tuberculosis represents a small percent of total extrapulmonary
TB forms, caused mainly by Mycobacterium tuberculosis.
Skin tuberculosis can be also highly variable in its clinical
appearance, significance, and prognosis. The form of the disease
depends on the virulence of the strain, the immune status of the
host, the portal of entry, the mode of internal spread, and the
adequacy of initial treatment. Lesions in the skin often represent
hematogenously or lymphatically dispersed disease from internal
foci of infection. Scrofuloderma and lupus vulgaris are much more
common and are seen in patients who are less immunosuppressed
and tuberculosis verrucosa cutis is highly seen in
patients who are immunocompetent. Leprosy (also known as
Hansen’s Disease) is a chronic, infectious disease involving
primarily the nerves and secondary the skin, mucosa and the eyes
of infected individuals. Leprosy is caused by Mycobacterium
leprae. Although this disease is curable since 1948, according to
WHO in 2013 there were registered 213.000 new cases of leprosy.
Considering the results of skin tests (biopsies, and secretions
tests) leprosy can be classified as: paucibacillary - few or absent
bacilli (tuberculoid leprosy, and borderline tuberculoid leprosy)
and multibacillary - numerous bacilli (lepromatous leprosy,
borderline lepromatous leprosy and borderline leprosy). Corroborating
clinical data with specific laboratory tests and biopsies of
the affected skin and nerves we establish the diagnosis and form
of these diseases; the tuberculin test has as correspondent
lepromin test. The treatment of cutaneous tuberculosis in most
cases is the same as for pulmonary tuberculosis. Early treatment
for leprosy prevents disabilities and scaring.
La tuberculose cutanee avec le principal agent pathogene Mycobacterium
tuberculosis represente un tres petit pourcent de la
tuberculose extra-respiratoire totale. TB cutanee est extremement
variable, du point de vue de la signification clinique et pronostique.
Le polymorphisme de la lesion depend de la virulence du bacille,
le statut immunitaire de l'hote, le lieu de passage vers le corps et
comment diffuser et mener l’efficacite du traitement initial. Les
lesions cutanees se produisent habituellement par diffusion
lymphatique ou hematogene d'une epidemie existante. Parmi les
formes de tuberculose cutanee et le lupus vulgaris scrofuloderme
l'on trouve couramment chez les patients immunodeprimes et
la tuberculose verruqueuse est plus frequente chez ceux
presentant une bonne immunite. La lepre (maladie de Hansen), les
maladies infectieuses, granulomatose chronique affecte les nerfs
peripheriques et les structures tissulaires superficielle primaires et
secondaires tels que la peau, les muqueuses et les yeux. L'agent
etiologique est Mycobacterium leprae. Bien que la maladie a ete
declaree curable depuis 1948 selon l'OMS 2013 il y avait 213 000
nouveaux cas. Les resultats de tests cutanes (secretions HP et
tests) peuvent classer la lepre dans: paucibacillaire - bacilles peu ou
absents (la lepre tuberculeuse, la tuberculose et la lepre borderline)
et multibacillaire - de nombreux bacilles (lepre lepromateuse, la
lepre lepromateuse borderline et la lepre borderline. Le traitement
de la tuberculose cutanee dans la plupart des cas est identique a
celui de la tuberculose et de la lepre pulmonaire; initie au debut de
l’handicap il empeche la deformation des cicatrices.