Cutaneous tuberculosis in China: A multicenter retrospective study of cases diagnosed between 1957 and 2013

Abstract

Background

China has one of the largest populations with tuberculosis worldwide. Cutaneous tuberculosis (CTB) is a rare manifestation of mycobacterial infection. Although CTB is well described, it is important to periodically revisit the prevailing clinical and epidemiological features in most populated countries such as China, India, and Indonesia, where tuberculosis is still a major health problem.

Objective

This retrospective study aimed to reevaluate the CTB cases in China in the past 50 years to btain a comprehensive insight into this multiplex entity.

Methods

Cases of diagnosed CTB with confirmed histology from four large medical centers in central China between 1957 and 2013 were collected and analyzed, including demographic data, clinical manifestations and pathological findings.

Results

Of the 1194 cases enrolled, there were 666 (55.78%) and 528 cases (44.22%) of true CTB and tuberculids, respectively. Erythema induratum of Bazin (EIB) was the most common CTB (35.8%), followed by lupus vulgaris (LV, 32.7%), tuberculosis verrucosa cutis (18.9%), papulonecrotic tuberculid (8.0%), scrofuloderma (2.8%), tuberculosis cutis ulcerosa (1.3%), penile tuberculids (0.4%), and lichen scrofulosorum (0.1%). EIB was the predominant tuberculid (80.87%), while LV the predominant true CTB (58.7%). The number of diagnosed CTB showed a decreasing trend in the 1960s and 1970s, then increased again, and peaked in the 1990s.

Conclusions

CTB is still a common problem in China. Chronologic changes of CTB cases reported in China over the past 50 years may reflect the prevalence transition of overall tuberculosis. CTB has diverse clinical presentations, and each subtype is characterized by specific gender predilection, duration, age, clinic, and pathological findings.

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