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Primary Tuberculosis of the Cheek skin: Difficulties in Diagnostic Procedure

Primary Tuberculosis of the Cheek skin: Difficulties in Diagnostic Procedure Background. Tuberculosis of the skin is rare disease in Europe. Diagnostic procedure is long and difficult. Aim. Aim of our manuscript is to point out that in differential diagnosis of chronic skin diseases, it is necessary to take tuberculosis into consideration as well. We represented rare case of cutaneous tuberculosis that required surgical procedure. Case report. A 46-year-old female, psychiatric patient, was referred to our clinic on surgical treatment of buccal abscess on the cheek. We extracted the teeth that were considered to be cause of inflammation, and the anthibiotic therapy was prescribed. Patient was seen after nearly two months. At the place of previous skin incision there was a visible fissure with surrounding erythematic and desquamation, and the fistula on the buccal mucous membrane. The findings of probatory biopsy showed elements of granulomatous inflammation. The first findings for Mycobacterium tuberculosis were negative. However, after five weeks the cultivation test was positive. The focus of infection was not found anywhere else. Conclusion. Despite of successful prevention programs over the world, tuberculosis is still public health problem in Balkan region. Cutanous tuberculosis, although very rare, is also present in this region. Early diagnose and patient's compliance is very important for further treatment.