Unilateral lymphoedema of lower limb: an unusual presenting feature of hidden tuberculosis verrucosa cutis of foot

BMJ Case Rep. 2020 Nov 3;13(11):e236587. doi: 10.1136/bcr-2020-236587.

Abstract

A 42-year-old Indian farmer presented with gradually progressive swelling of the right lower limb for the last 20 years. There were few verrucous plaques over the right foot for the same duration. Those plaques were initially ignored and mistaken as lymphoedema-induced secondary changes by primary care physicians. Histopathology of the skin lesion showed pseudoepitheliomatous hyperplasia with upper dermal granulomatous infiltrate and a diagnosis of tuberculosis verrucosa cutis was suspected. Subsequently, the lesions as well as lymphoedema improved significantly with antitubercular therapy.

Keywords: TB and other respiratory infections; dermatology; infections; skin; tropical medicine (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Diagnosis, Differential
  • Foot
  • Humans
  • Lower Extremity
  • Lymphedema / diagnosis
  • Lymphedema / etiology*
  • Male
  • Mycobacterium tuberculosis / isolation & purification
  • Skin / microbiology
  • Skin / pathology*
  • Tuberculosis, Cutaneous / complications*
  • Tuberculosis, Cutaneous / diagnosis