{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:31:52Z","timestamp":1784871112334,"version":"3.55.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Dis Poverty"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cutaneous tuberculosis (CTB) is an unusual manifestation of extrapulmonary tuberculosis, accounting for only 1.0%\u20131.5% of cases. It presents with a wide range of clinical morphologies, often mimicking other dermatoses such as fungal infections, leprosy, or sarcoidosis. Among its different variants, the ulcerative form is particularly rare and clinically deceptive. Reporting rare presentation is important to raise awareness among physicians, as early recognition and prompt treatment are essential to prevent complications such as scarring, contractures, or malignant transformation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We report the case of a 24-year-old Malian male admitted to the National Institute for Infectious Diseases Lazzaro Spallanzani. The patient presented with a 4-month history of ulcerative skin lesions on the chest, neck, and left leg, accompanied by systemic symptoms including asthenia, cachexia, and generalized lymphadenopathy. Imaging revealed extensive bilateral psoas abscesses, vertebral involvement consistent with spondylodiscitis, and signs of empyema necessitans. Polymerase chain reaction (PCR) testing of drained abscess fluid confirmed\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      complex. Skin biopsy histology and PCR further supported the diagnosis of CTB. The patient was treated with standard anti-tuberculosis therapy (isoniazid, rifampicin, ethambutol, pyrazinamide) alongside broad-spectrum antibiotics. After 30\u00a0days, partial improvement of skin lesions was observed, although complete resolution was not achieved after 8\u00a0months of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenge and chronicity of CTB, particularly in the ulcerative presentation. The patient developed disseminated tuberculosis with cutaneous involvement without any recent travel or known tuberculosis exposure, and the probable etiology is latent reactivation. There should be a high index of suspicion for CTB in patients presenting with indolent, atypical skin lesions, particularly those from an endemic region. Early diagnosis and prolonged therapy are crucial to avoid long-term sequelae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s40249-025-01377-7","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T10:22:22Z","timestamp":1762424542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Atypical ulcerative cutaneous tuberculosis revealing disseminated mycobacterial infection: case report with diagnostic and therapeutic challenges"],"prefix":"10.1186","volume":"14","author":[{"given":"Serena","family":"Vita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mariano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Faraglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Colombo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Scarabello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Gualano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Palazzolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberta","family":"Villanacci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia Maria","family":"Olivieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Del Nonno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Mirante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Ianniello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"D\u2019Abramo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Nicastri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"1377_CR1","unstructured":"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis#:~:text=Worldwide%2C%20TB%20is%20the%2013th,women%20and%201.2%20million%20children. Accessed 23 April 2025."},{"key":"1377_CR2","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.clindermatol.2019.01.008","volume":"37","author":"Q Chen","year":"2019","unstructured":"Chen Q, Chen W, Hao F. Cutaneous tuberculosis: a great imitator. Clin Dermatol. 2019;37:192\u20139. https:\/\/doi.org\/10.1016\/j.clindermatol.2019.01.008.","journal-title":"Clin Dermatol"},{"key":"1377_CR3","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/j.tube.2014.12.006","volume":"95","author":"L van Zyl","year":"2015","unstructured":"van Zyl L, du Plessis J, Viljoen J. Cutaneous tuberculosis overview and current treatment regimens. Tuberculosis. 2015;95:629\u201338.","journal-title":"Tuberculosis"},{"issue":"6","key":"1377_CR4","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/j.jaad.2021.12.063","volume":"89","author":"S Kaul","year":"2023","unstructured":"Kaul S, Kaur I, Mehta S, Singal A. Cutaneous tuberculosis. Part I: pathogenesis, classification, and clinical features. J Am Acad Dermatol. 2023;89(6):1091\u2013103. https:\/\/doi.org\/10.1016\/j.jaad.2021.12.063.","journal-title":"J Am Acad Dermatol"},{"key":"1377_CR5","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1590\/abd1806-4841.20142334","volume":"89","author":"JBD Santos","year":"2014","unstructured":"Santos JBD, Figueiredo AR, Ferraz CE, Oliveira MHD, Silva PGD, Medeiros VLSD. Cutaneous tuberculosis: epidemiologic, etiopathogenic and clinical aspects-Part I. An Bras Dermatol. 2014;89:219\u201328. https:\/\/doi.org\/10.1590\/abd1806-4841.20142334.","journal-title":"An Bras Dermatol"},{"issue":"6","key":"1377_CR6","first-page":"494","volume":"3","author":"B Kumar","year":"1999","unstructured":"Kumar B, Muralidhar S. Cutaneous tuberculosis: a twenty-year prospective study. 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Cutaneous tuberculosis treated at the Dermatological Clinic, Medical Academy, in Cracow 1963\u20131987. I. Epidemiological analysis. Przegl Dermatol. 1990;77(1):34\u20139. (In Polish).","journal-title":"Przegl Dermatol"}],"container-title":["Infectious Diseases of Poverty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-025-01377-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40249-025-01377-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40249-025-01377-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T18:02:59Z","timestamp":1764093779000},"score":1,"resource":{"primary":{"URL":"https:\/\/idpjournal.biomedcentral.com\/articles\/10.1186\/s40249-025-01377-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1377"],"URL":"https:\/\/doi.org\/10.1186\/s40249-025-01377-7","relation":{},"ISSN":["2049-9957"],"issn-type":[{"value":"2049-9957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"assertion":[{"value":"3 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2025","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The first affiliation of this article has been updated","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical Committee approval was not required due to the observational nature of the study. Patient's written informed consent for publication was collected.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and informed consent"}},{"value":"Patient's written informed consent for publication was collected.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors have no competing of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"113"}}