Evaluation of laboratory diagnosis for cutaneous tuberculosis.
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Date
2016-07
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Abstract
Background and Aim: Cutaneous tuberculosis (CTB) is still difficult to diagnose
due to its varied clinical presentation and limitations of diagnostic methods.
The aim of this study was to evaluate the results of diagnostic laboratory tests
available for CTB. Materials and Methods: Twenty-six skin biopsy specimens
belonging to clinically suspected cases of CTB were studied retrospectively. The
specimens were divided into two portions, one part processed for histopathological
evaluation and the other was used for microscopy and inoculation for the isolation
of mycobacteria. Polymerase chain reaction (PCR) technique was applied to
14 of 26 specimens to detect Mycobacterium tuberculosis complex (MTBC)
DNA. Results: Of the 26 biopsy specimens, 11 were confirmed as CTB by
identification of MTBC in culture and/or histopathologic affirmation. Of these,
four were lupus vulgaris, four were TB verrucosa cutis, one was scrofuloderma,
one was primary inoculation TB, and one was periorifical CTB. Culture for
mycobacteria was positive for five (45.45%) specimens, while histopathologic
affirmation was obtained in ten (90.90%) specimens. Acid-fast Bacilli were not
demonstrated in any of the specimens on microscopic examination. The PCR
was found to be applied to six of the 11 specimens diagnosed as CTB and was
positive in two specimens (33.3%), which were positive for growth in culture
and histopathological correlation. Conclusion: The recovery rate of MTBC from
biopsy specimens was found to be satisfactory for CTB with histopathological
correlation, but the combination of culture with a rapid method, PCR, may
improve the diagnostic rate.
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Keywords
Acid‑fast staining, culture, cutaneous tuberculosis, diagnosis, polymerase chain reaction
Citation
Afsar Ilhan, Afsar Fatma Sule. Evaluation of laboratory diagnosis for cutaneous tuberculosis. Indian Journal of Pathology & Microbiology. 2016 July-Sept 59(3): 274-278.