English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Cutaneous tuberculosis constituting a small fraction about 1.5% of all forms of extra pulmonary tuberculosis, manifests as different clinical types across the cell mediated immunity spectrum. The clinical manifestations like lupus vulgaris, tuberculosis verrucosa cutis (TBVC), scrofuloderma, tuberculous gumma, tuberculous chancre, miliary tuberculosis, papulonecrotic tuberculid and lichen scrofulosorum may be dependent on the route of infection (endogenous or exogenous), the immune status of the patient and previous sensitization with tuberculosis [1]. Tuberculous gummas, also called metastatic tuberculous abscesses, are usually seen in malnourished children and in immunocompromised states, as result of hematogenous dissemination of tubercle bacilli from an underlying focus and occur during periods of lowered immunity [2]. It usually presents as one or multiple non-tender subcutaneous nodules, whi ch slowly soften, or cold abscesses with fluctuant swelling. Whereas TBVC results from direct inoculation of the bacilli into the skin of previously infected patients having intact immunity. It manifests as a large verrucous plaque with finger like projections at the margins. Co-existence of different types of cutaneous tuberculosis has been described in various literatures in the form of scrofuloderma with tuberculosis verrucosa cutis [3], lupus vulgaris with tuberculosis verrucosa cutis, papulonecrotic tuberculid with lichen scrofulosorum and lupus vulgaris with papulonecrotic tuberculid [4]. Interestingly, we came across a rare presentation in a 43 year immunocompetent female presenting with both subcutaneous skin abscesses in multiple sites (low immunity) along with verrucous plaques over B/L feet (high immunity), proven histopatholigically as TB gumma and TBVC respectively.

Coexistence of tuberculous gumma with tuberculosis verrucous cutis (TBVC) in an immunocompetent female