Tuberculosis of skin and subcutaneous tissue
ICD-10 A18.4 is a billable code used to indicate a diagnosis of tuberculosis of skin and subcutaneous tissue.
Tuberculosis of the skin and subcutaneous tissue is a rare manifestation of extrapulmonary tuberculosis, which occurs when Mycobacterium tuberculosis infects the skin or subcutaneous layers. This condition can present as localized lesions, ulcers, or nodules, often resembling other dermatological conditions, making diagnosis challenging. The lesions may be painless or painful and can vary in appearance from erythematous nodules to necrotic ulcers. Diagnosis typically involves a combination of clinical evaluation, skin biopsy, and microbiological tests, including culture and PCR for Mycobacterium tuberculosis. Treatment usually involves a multi-drug regimen similar to that used for pulmonary tuberculosis, including isoniazid, rifampicin, ethambutol, and pyrazinamide, administered over a period of six months or longer. Monitoring for treatment efficacy and potential drug resistance is crucial, as is adherence to public health protocols, including contact tracing and isolation of infectious cases. Given the potential for drug-resistant strains, healthcare providers must remain vigilant in managing and reporting cases to public health authorities.
Detailed clinical notes describing lesion characteristics, biopsy results, and treatment plans.
Patients presenting with skin lesions that may be mistaken for other dermatological diseases.
Awareness of tuberculosis risk factors and history in patients with skin lesions.
Comprehensive documentation of diagnostic tests, treatment regimens, and follow-up care.
Patients with a known history of tuberculosis presenting with skin manifestations.
Monitoring for drug resistance and adherence to treatment protocols.
Used when a biopsy is performed to confirm tuberculosis.
Document the site, size, and appearance of the lesion.
Dermatologists should ensure thorough documentation of the biopsy process.
Common symptoms include painless or painful nodules, ulcers, and erythematous lesions that may resemble other skin conditions.
Diagnosis typically involves a skin biopsy, culture for Mycobacterium tuberculosis, and possibly PCR testing.
Treatment usually involves a multi-drug regimen similar to that for pulmonary tuberculosis, including isoniazid and rifampicin.
Public health measures include contact tracing, reporting to health authorities, and isolation of infectious patients.
