CUTANEOS TUBERCOLOSIS IN TIGRAY, ETHIOPIA

Terranova M., Padovese V., Calcaterra R., Franco G., Morrone A.

17th CONGRESS OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
Paris, 17-21 September 2008

FP0131 CUTANEOUS TUBERCULOSIS IN TIGRAY, ETHIOPIA
M. Terranova1, V. Padovese1, R. Calcaterra2, G. Franco3, A. Morrone4 1Italian Dermatological Centre, IDC, Mekele, Ethiopia, 2Department of Research, National Institute for health, migration and poverty, 3Department of Preventive
Medicine for Migration, Tourism and Tropical Dermatology, San Gallicano Institute, 4Director General, National Institute for health, migration and poverty, Rome, Italy

Background. Tuberculosis is still a serious problem in both developing and developed countries and its resurgence in the era of HIV/AIDS has rejuvenated the interest in this global health problem. In Ethiopia, prevalence rate of infection was 533 over 100.000 inhabitants for 2004. Cutaneous tuberculosis represents only 2% of extrapulmonary
locations.
Methods. We analyzed the cases of cutaneous tuberculosis observed at the Italian Dermatological Centre (IDC) in Mekele, capital of Tigray, the northern region of Ethiopia, between January and December 2006. Clinical diagnosis was confirmed with fine-needle aspiration cytology (FNAC) and Ziehl Neelsen or Methylene blue staining (showing acid fast bacilli or caseation necrosis) and histological investigations.
Results. During 1 year of clinical activity, 102 cases of cutaneous tuberculosis were observed; among these, female represented 53.5% of cases and pediatric cases were 13 (12.7% of cases). Scrofuloderma and lichen scrofulosorum represented the most prevalent clinical manifestations while lupus vulgaris, tuberculosis verrucosa cutis and gumma were few cases. The first affected area from scrofuloderma was the axilla followed by thoracic area; for lichen scrofulosorum it was represented by limbs. Among our patients, 20 were HIV positive (19.6% of total cases). History of persistent
skin lesions after complete cycle of anti-tuberculosis treatment in many of our patients, confirm presence of drug resistance to tuberculosis infection in this area.
Conclusions. Tuberculosis represents spread infection in all Ethiopia. Delayed diagnosis and treatment of tuberculosis result in severe disease and higher mortality; it also leads to an increased period of infectivity in the community. Cutaneous
tuberculosis, an important extra-pulmonary form, is commonly seen in our dermatological practice in Ethiopia in adult as well as pediatric patients. This form should be studied and recognized because it may indicate visceral forms of
tuberculosis and help diagnosis of first or relapsing infection as well as a drugresistance cases.

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