Pulmonary Tuberculosis and Cutaneous Mycobacterial Infection in a Patient with Incontinentia Pigmenti

• Published in: Pediatric dermatology 2004-11, Vol.21 (6), p.660-663
• Main Authors: Senturk, Nilgün, Aydin, Fatma, Haciomeroglu, Pelin, Yildiz, Levent, Totan, Mehmet, Canturk, Tayyar, Turanli, Ahmet Yaşar
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial diseases of the respiratory system; BCG Vaccine - adverse effects; Biological and medical sciences; Child; Dermatology; Female; Human bacterial diseases; Humans; Incontinentia Pigmenti - complications; Incontinentia Pigmenti - etiology; Infectious diseases; Lupus Vulgaris - complications; Lupus Vulgaris - etiology; Lupus Vulgaris - pathology; Medical sciences; Mycobacterium Infections - complications; Pigmentary diseases of the skin; Skin Diseases, Bacterial - complications; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - immunology
• ISSN: 0736-8046; 1525-1470
• DOI: 10.1111/j.0736-8046.2004.21610.x

:  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‐Guérin (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.