Pulmonary tuberculosis and cutaneous mycobacterial infection in a patient with incontinentia pigmenti.
Lupus vulgaris is reinfection tuberculosis of the skin and may result from direct extension, or hematogenous or lymphatic spread from a tuberculosis focus. Lupus vulgaris following bacille Calmette-Guerin (BCG) vaccination is a rare entity. Incontinentia pigmenti is an X-linked dominant genodermatosis in which vesicular, verrucous, and pigmented lesions are associated with various developmental defects. There is evidence of altered immunologic reactivity in some patients with incontinentia pigmenti. A 12-year-old girl hospitalized for pulmonary tuberculosis presented with bizarre-shaped brown macules following Blaschko lines on the left deltoid area, compatible with incontinentia pigmenti, which had appeared following BCG vaccination at the age of 7 years. Histopathologic examination found noncaseated granulomas in the dermis. Antituberculous treatment for pulmonary and cutaneous tuberculosis was initiated along with genetic counseling. Immunologic abnormalities have been reported in conjunction with incontinentia pigmenti. Simultaneous occurrence of pulmonary and cutaneous tuberculosis in our patient might be either coincidental or indicate derangements in the cellular immune system.
Senturk
Nilgün
N
Department of Dermatology, Faculty of Medicine, Ondokuz Mayis University, 55139 Kurupelit/Samsun, Turkey. nilsenturk@yahoo.com
Aydin
Fatma
F
Haciomeroglu
Pelin
P
Yildiz
Levent
L
Totan
Mehmet
M
Canturk
Tayyar
T
Turanli
Ahmet Yaar
AY
D001500:BCG Vaccine / Q000009:adverse effects; D002648:Child; D005260:Female; D006801:Humans; D007184:Incontinentia Pigmenti / Q000150:complications* / Q000209:etiology; D008177:Lupus Vulgaris / Q000150:complications / Q000209:etiology / Q000473:pathology; D009164:Mycobacterium Infections / Q000150:complications*; D017192:Skin Diseases, Bacterial / Q000150:complications*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000276:immunology
D001500:BCG Vaccine