{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:20:18Z","timestamp":1767190818792,"version":"3.48.0"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Tuberculosis (TB) remains a major public health concern in endemic regions, with varied and sometimes unusual clinical manifestations in children. TB may present with cutaneous manifestations known as tuberculids, which are a type of hypersensitivity reaction to mycobacterial TB elsewhere in the body. Lichen scrofulosorum (LS) is one of the tuberculids. Here we present a case of a preschool-aged boy who presented with disseminated TB and cutaneous findings such as multiple soft tissue swellings over limbs along with LS. The child was treated with anti-tubercular therapy along with nutritional support. He showed resolution of skin and respiratory symptoms within weeks, with no recurrence or adverse effects on follow-up. Our case highlights a rare cutaneous manifestation of disseminated TB in children. In endemic regions, early recognition of these cutaneous signs in children with constitutional symptoms of TB is crucial for timely diagnosis and management of TB.<\/jats:p>","DOI":"10.1136\/bcr-2025-268359","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:35:16Z","timestamp":1767180916000},"page":"e268359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Disseminated tuberculosis with atypical cutaneous manifestations in a child"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0704-069X","authenticated-orcid":false,"given":"Shalini","family":"Verma","sequence":"first","affiliation":[{"name":"Paediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nimesh","family":"Saxena","sequence":"additional","affiliation":[{"name":"Paediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-1439","authenticated-orcid":false,"given":"Chandra Kanta","family":"Kumar","sequence":"additional","affiliation":[{"name":"Paediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-1494","authenticated-orcid":false,"given":"Arpita","family":"Bhriguvanshi","sequence":"additional","affiliation":[{"name":"Paediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parul","family":"Verma","sequence":"additional","affiliation":[{"name":"Dermatology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2025123106150966000_18.12.e268359.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-024-20664-w","article-title":"Global, regional, and national burden of tuberculosis and attributable risk factors for 204 countries and territories, 1990-2021: a systematic analysis for the Global Burden of Diseases 2021 study","volume":"24","author":"Yang","year":"2024","journal-title":"BMC Public Health"},{"key":"2025123106150966000_18.12.e268359.2","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1016\/j.jiph.2023.10.009","article-title":"Prevalence and factors associated with tuberculosis infection in India","volume":"16","author":"Selvaraju","year":"2023","journal-title":"J Infect Public Health"},{"key":"2025123106150966000_18.12.e268359.3","first-page":"494","article-title":"Cutaneous tuberculosis: a twenty-year prospective 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Pulmonary Tuberculosis With Left Pleural Effusion and Lichen Scrofulosorum: A First-of-Its-Type Report. 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