Abces tuberculos metastatic – marker de debut al unei tuberculoze miliare

Abstract

Cutaneous tuberculosis is a rare disease in our country, of which, most often diagnosed are lupus vulgaris and scrofuloderma. We present a 55 year old male patient, with an important family history (pulmonary tuberculosis of his father) and personal risk factors (silicosis, tobacco, alcohol ingestion), who presented to our department for an indolent, nonhealing ulcer on the left hypothenar eminence. Histopathology of the skin made the final diagnosis of cutaneous tuberculosis, the course being toward healing after specific treatment (isoniaside, ethambutol, rifampicin, pyrazinamide). We have made this presentation because of the way of onset in an apparently healthy person, one year before other manifestations (joints, pulmonary and lymph nodes), the clinical form and site of the lesion (unusual site for a skin ulcer), the preceding medical tour (neurology, rheumatology, pulmonary diseases, orthopedic department) until diagnosis. We just wanted to emphasize the importance of a complete and accurate clinical exam of a patient.