Tuberculosis of the scalp: the tubercle bacilli has not ceased to surprise us
Adil Zegmout, Hicham Souhi
Corresponding author: Adil Zegmout, Service de Pneumologie, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc
Received: 19 Jun 2017 - Accepted: 26 Jun 2017 - Published: 13 Sep 2017
Domain: Dermatology,Infectious disease
Keywords: Tuberculosis, scalp, tubercle bacilli
©Adil Zegmout et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Adil Zegmout et al. Tuberculosis of the scalp: the tubercle bacilli has not ceased to surprise us. Pan African Medical Journal. 2017;28:28. [doi: 10.11604/pamj.2017.28.28.13131]
Available online at: https://www.panafrican-med-journal.com/content/article/28/28/full
Tuberculosis of the scalp: the tubercle bacilli has not ceased to surprise us
Adil Zegmout1,&, Hicham Souhi2
1Service de Pneumologie, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc, 2Service de Pneumologie, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc
&Corresponding author
Adil Zegmout, Service de Pneumologie, Hôpital Militaire d'Instruction Mohamed
V, Rabat, Maroc
A 52-year-old men was referred with a 6-months history of a 3cm single skin lesion, erythematous, not pruriginous, with a verrucous surface, surmounted by scales, with circinated border. His history included weight loss of 8kg, but no other associated symptoms or contact with tuberculosis patients. Erythrocyte sedimentation rate (ESR) was slightly elevated at 82mm in the first hour. Mycological sampling was negative. Tuberculin skin test was positive (15mm) and anti-human immunodeficiency virus serology was negative. A skin biopsy was performed and sent for histopathology and culture. The skin biopsy showed inflammatory granuloma composed mostly of epithelioid cells and giant cells, consistent with tubercular granuloma. Mycobacteria were absent on Ziehl-Neelsen staining, tubercle bacilli were isolated and grown in culture from the lesion and confirmed a scalp localisation of tuberculosis. The scalp localization of tuberculosis very rare and not sufficiently described in the literature and demonstrates the multifaceted aspect of tuberculosis, which continues to yield surprises with its unusual clinical manifestations. Antitubercular chemotherapy consisting of isoniazid, rifampicin, ethambutol and pyrazinamide was started. Follow-up at the end of treatment at 6 months showed a clinical remission.
Figure 1: clinical photograph showing the lesion of scalp in occipital region