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Our Dermatol Online. 2013; 4(4): 462
Date of submission:  05.09.2013 / acceptance: 23.09.2013
Conflicts of interest: None

Tejinder Kaur, Alpna Thakur, Kritika Pandey, Suresh Kumar Malhotra, Karan Jit Pal Singh Puri


Elena Chiticariu, MD PhD1, Anca Chiriac MD PhD2, Prof. Caius Solovan1

1Dermatology,University of Medicine and Pharmacy,Timisoara-Romania
2Nicolina Medical Center, Department of Dermatology, Iasi-Romania
How to cite an article: Chiticariu E, Chiriac A, Solovan C. comment: Cutaneous TB profile in North West Punjab, India: a retrospective data analysis. Our Dermatol Online. 2013; 4(4): 462.

Although it is a “disease of antiquity”, nicely described by Kaur T et al, tuberculosis is still a challenge in the modern medicine. The authors highlighted the role of HIV coinfection, but we don’t have to forget about the role of anti-TNF therapies (widely prescribed nowadays) in reactivating tuberculosis infection, especially in endemic regions [1]. Another important point that we could observe here is the important number of cases with a negative Mantoux test (approximately 36%). As we showed previously, Mantoux or tuberculin skin test (TST) is not a reliable technique in detecting the infection. We registered positive tuberculin skin test (defined in the context of biologic therapy as induration >5 mm) in 51% of nondermatologic subjects, respectively 70% of the patients with psoriasis [2]. Among them, 50% of psoriatic patients and 28% of nondermatologic subjects had an induration >10 mm (unpublished data). We have also reported the reactivation of TB under anti-TNFα therapy [3]. According to World Health Organization, the incidence rate of tuberculosis in Romania was estimated to 101/100000 population [4]. However, even if Romania is an endemic country, we mostly see pulmonary tuberculosis, cutaneous tuberculosis being very rare. Thus, we need to compliment the authors for a very clear and didactic presentation of different forms of cutaneous tuberculosis.
1. Hernandez C, Cetner AS, Jordan JE, Puangsuvan SN, Robinson JK: Tuberculosis in the age of biologic therapy. J Am Acad Dermatol. 2008;59:363–80.
2. Solovan C, Chiticariu E, Timofte A, Stoia-Djeska I: Tuberculosis infection versus anti-tumor necrosis factor therapy: screening challenges in psoriatic patients. J Drug Assessment. 2012;1:65-7.
3. Solovan C, Chiticariu E: Psoriasis, Anti-Tumor Necrosis Factor Therapy, and Tuberculosis: Report of Three Challenging Cases and Literature Review. Infectious Diseases and Therapy. 2013;2:59-73.
4. Global tuberculosis report 2012, World Health Organization, 2012.

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