Back issues No.1 - 2005 / Case Report  

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Tuberculous gumma(Cutaneous metastatic tuberculous abscess)
Mei-ju Ko, Chia-cheng Wu, Hsien-Ching Chiu
Dermatol Sinica 23:27-31,2005

Tuberculous gumma, also called metastatic tuberculous abscess, is a multibacillary type of skin tuberculosis caused by hematogenous spread of mycobacteria from a primary focus. We report a patient with tuberculous gumma on the right shin. The 68-year-old woman with pulmonary miliary tuberculosis and an occult non-Hodgkin lymphoma was found to have a pigeon-egg sized, soft nodule on the right shin. Histopathologic examination showed granulomatous inflammation with occasional giant cells and a pronounced inflammatory infiltrate in the deep dermis and subcutaneous tissue. Extensive necrosis with abscess formation was also noted. Acid-fast stain revealed multiple acid-fast bacilli. The tissue culture yielded Mycobacterium tuberculosis. The patient was treated with rifampin, isoniazid, pyrazinamide, and ethambutol daily for the initial 2 months, and isoniazid and rifampin for 4 more months. No recurrence of any skin lesion has been noted.

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