Outcome of short course chemotherapy of tuberculosis verrucosa cutis in a child

Tuberculosis verrucosa cutis (TBVC) is an exogenous form of cutaneous tuberculosis (TB) due to accidental inoculation of mycobacterium TB from tubercular material like sputum into the exposed areas of skin with the minor traumatic lesion of a previously infected individual with intact cell-mediated immunity. In India, TBVC often occurs in the lower extremities and involvement of the elbow is unusual. Excellent response to anti-TB treatment (ATT) is the characteristic feature of TBVC. A case of TBVC at the left elbow in a 10-year-old boy with partial resolution at the end of ATT is reported. Chronicity and the initial size of skin lesion may be one of the reasons for the incomplete resolution of TBVC even after short-course chemotherapy with daily isoniazid, rifampicin, ethambutol and pyrazinamide for the first 2 months followed by 4 months of daily isoniazid and rifampicin in some cases. Topical application of a keratolytic drug like 3% salicylic acid may be effective in further thinning of residual lesions of TBVC.