Multiple Tuberculosis Verrucosa Cutis Lesions on One Foot: A Case Report

Tuberculosis verrucosa cutis (TVC) is a form of cutaneous tuberculosis caused by an exogenous inoculation of Mycobacterium tuberculosis in previously infected or sensitized individuals. Tuberculin sensitivity is moderate to high in these patients. In adults tuberculosis verrucosa cutis occurs commonly on the dorsal aspect of fingers and toes but in children it often occurs on gluteal region and lower extremities. A 36-year-old man presented with verrucous lesion on his right foot which was present for 9 years. It was understood from history that he worked as a rancher. On dermatologic examination 3 verrucous hiperkeratotic plaques were present on medial and plantar aspects of the right foot and also on dorsal aspect of the forth toe of the same foot. In serial biopsy specimens which was obtained from the lesions, histopathologic findings compatible with tuberculosis verrucosa cutis was observed. On the chest X-ray and thoracic tomography there were no sign of infection related with tuberculosis and changes secondary to previous tuberculosis on the left lung were observed. After commencing anti tuberculosis therapy regime consisting of isoniazid, rifampicin, morphazinamide and ethambutol obvious healing in the lesions occurred. This rarely reported case in Turkey showed the importance of histopathologic changes observed in serial biopsies in diagnosis of TVC besides history and clinical course of the lesions. It also emphasized the role of response to treatment in confirming the diagnosis