Scrofuloderma in a 1-year-old girl with severe malnutrition: a case report

  • Madeleine Ramdhani Jasin Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Fahreza Aditya Neldy Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Darmawan Budi Setyanto Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Gufron Nugroho Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Valerie Sunhaji Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Maria Francisca Ham Medical Education Program, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
Keywords: tuberculosis, cutaneous, scrofuloderma, children, extrapulmonary

Abstract

Tuberculosis (TB) remains a global burden and a leading cause of mortality due to infectious diseases worldwide. In 2020, 845,000 new TB cases (312 per 100,000 population) were diagnosed, with 96,000 deaths, including 4,700 deaths of TB with HIV. Tuberculosis typically affects the lungs, but it can also affect other organs, a condition termed extrapulmonary TB. In 2020, 16% of all TB cases had extrapulmonary manifestations.1 The first case of TB affecting the skin was reported in 1826.2,3 There are many types of cutaneous TB; one of the most common is scrofuloderma, more often found in children and young adults.4 Scrofuloderma starts with a lesion in a lymph node, bone, muscle, or tendon that spreads to the skin.5 The lesion progresses very slowly and is usually not painful. Therefore, many patients wait to seek treatment until an advanced stage, leading to poor prognosis.3 In this report, we present a case of a severely malnourished one-year-old girl with scrofuloderma.

References

1. World Health Organization. Global tuberculosis report 2020. Geneva: World Health Organization; 2020.
2. Vashisht P, Sahoo B, Khurana N, Reddy BSN. Cutaneous tuberculosis in children and adolescents: a clinicohistological study. J Eur Acad Dermatol Venereol. 2007;21:40-7. DOI: https://doi.org/10.1111/j.1468-3083.2006.01858.x.
3. Cantres-Fonseca OJ, Rodriguez-Cintrón W, Olmo-Arroyo FD, Baez-Corujo S. Extrapulmonary tuberculosis: an overview. In: Chauhan NS, editor. Role of microbes in human health and diseases. London: InTechOpen; 2018. DOI: https://doi.org/10.5772/intechopen.81322.
4. Malavia G, Parikh R, Bhate A. A rare case of scrofuloderma. SSRG – Int J Med Scien. 2017;4:12-14. DOI: https://doi.org/10.14445/23939117/IJMS-V4I8P104.
5. Kim GW, Park HJ, Kim HS, Kim SH, Ko HC, Kim BS, et al. Delayed diagnosis of scrofuloderma misdiagnosed as a bacterial abscess. Ann Dermatol. 2012;24:70-3. DOI: https://doi.org/10.5021/ad.2012.24.1.70.
6. Kementerian Kesehatan Republik Indonesia. Petunjuk teknis manajemen dan tatalaksana tuberkulosis anak. Jakarta: Kementerian Kesehatan Republik Indonesia; 2016.
7. World Health Organization. Guidance for national tuberculosis programmes on the management of tuberculosis in children. 2nd ed. Geneva: World Health Organization; 2014.
8. Unit Kelompok Kerja Respirologi Ikatan Dokter Anak Indonesia. Tuberkulosis dengan keadaan khusus, in: Pedoman nasional tuberkulosis anak. 2nd edition with revision. Jakarta: UKK Respirologi PP IDAI; 2008. p. 71-2.
9. World Health Organization. Implementing the WHO stop TB strategy. Geneva: World Health Organization; 2008.
10. Soeroso NN, Harina EG, Yosi A. A very rare case of scrofuloderma with multiple cervical lymphadenitis tuberculosis. Respir Med Case Rep. 2019;27:1-3. DOI: https://doi.org/10.1016/j.rmcr.2019.100842.
11. Khadka P, Koirala S, Thapaliya J. Cutaneous tuberculosis: Clinicopathologic arrays and diagnostic challenges. Dermatol Res Pract. 2018;2018:72019973. DOI: https://doi.org/10.1155/2018/7201973.
12. Tadele H. Scrofuloderma with disseminated tuberculosis in an Ethiopian child: a case report. J Med Case Reports. 2018;12:371. DOI: https://doi.org/10.1186/s13256-018-1927-1
13. Djuanda A, Hamzah M, Aisah S. Ilmu kesehatan kulit dan kelamin. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2007.
14. . Bagherirad M, Athan E, Harris OC. Forgotten but not gone - scrofuloderma in a migrant student from India. Australas Med J. 2013;6:371–3. DOI: https://doi.org/10.21767/AMJ.2013.1759.
15. Dos Santos JB, Figueiredo AR, Ferraz CE, de Oliveira MH, da Silva PG, de Medeiros VLS. Cutaneous tuberculosis: diagnosis, histopathology and treatment - Part II. An Bras Dermatol. 2014;89:545–55. DOI: https://doi.org/10.1590/abd1806-4841.20142747
16. Nursyamsi HS, Rasjid M. TBC dengan tes mantoux di bagian ilmu kesehatan anak RSU Prof. DR.R.D.Kandou Manado periode 2001-2006. Inspirasi. 2011;1:65-90.
17. Marianto, Kosim H, Mahariski PA, Christopher PM. Update on scrofuloderma. Bali Dermatol Venereol J. 2019;2:34-41. DOI: https://doi.org/10.15562/bdv.v2i2.20
18. Ramirez-Lapausa M, Menendez-Saldana A, Noguerado-Asensio A. Extrapulmonary tuberculosis: an overview. Rev Esp Sanid Penit. 2015;17:3-11. PMID: 16300038.
19. Nurman J, Darmawan BS. Skrofuloderma pada anak: Penyakit yang terlupakan? Sari Pediatri. 2010;12:108-15. DOI: https://doi.org/10.14238/sp12.2.2010.108-15.
20. Amar T, Patel Z, Rewat M. Scrofuloderma: a rare case report on cutaneous tuberculosis. Clin Med Rev Case Rep. 2020;7:330. DOI: https://doi.org/10.23937/2378-3656/1410330.
21. Bleeker-Rovers CP, De Vries HJC. Dermatologic manifestations of systemic infections. In: Cohen J, Powderly WG, Opal SM, editors. Infectious diseases. 4th ed. Amsterdam: Elsevier; 2017. p. 113-21. DOI: https://doi.org/10.1016/B978-0-323-04579-7.00012-5.
Published
2023-12-14
How to Cite
1.
Jasin M, Neldy F, Setyanto D, Nugroho G, Sunhaji V, Ham M. Scrofuloderma in a 1-year-old girl with severe malnutrition: a case report. PI [Internet]. 14Dec.2023 [cited 22Feb.2024];63(6):511-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2737
Section
Case Report
Received 2021-08-05
Accepted 2023-12-14
Published 2023-12-14