Tuberculous cellulitis in a patient with chronic kidney disease and polymyalgia rheumatica.

Nov 2012

Daido-Horiuchi Y, Kikuchi Y, Kobayashi S, Fujii T, Oshima S, Kondo T.

Source

Department of Internal Medicine, Mishuku Hospital, Japan.

Abstract

An 89-year-old man with advanced renal failure, polymyalgia rheumatica and a past history of tuberculosis was admitted with a high fever. Erythema and swelling appeared in the femoral region. Since the cellulitis failed to respond to antibiotic therapy, a skin biopsy was performed. The specimen showed the presence of epithelioid cell granuloma and panniculitis. Acid-fast organisms were found on Ziehl-Neelsen staining. A polymerase chain reaction test of tuberculosis was positive. Although a diagnosis of miliary tuberculosis was suggested, examinations of a bone marrow biopsy and fundoscopy revealed normal results. The patient's symptoms improved following treatment with isoniazid, rifampicin and ethambutol. This case represents an unusual presentation of tuberculous cellulitis in an immunocompromised patient.

Internal Medicine

Dissecting cellulitis of the scalp treated with rifampicin and isotretinoin: case reports

Dissecting cellulitis of the scalp treated with rifampicin and isotretinoin: case reports

Cutis. 2008 Sep

Georgala S, Korfitis C, Ioannidou D, Alestas T, Kylafis G, Georgala C.
Department of Dermatology, University of Athens, Andreas Sygros Hospital, Greece.

Dissecting cellulitis of the scalp, or perifolliculitis capitis abscedens et suffodiens, is an uncommon chronic suppurative disease of the scalp manifested by follicular and perifollicular inflammatory nodules that suppurate and undermine, forming intercommunicating sinuses, and leading to scarring alopecia. Treatment generally fails to obtain a permanently successful result; thus, many therapeutic options have been proposed. We report 4 cases of dissecting cellulitis of the scalp successfully treated with oral rifampicin and oral isotretinoin. To our knowledge, this is the first report of oral rifampicin used concomitantly with oral isotretinoin in this disease entity. We also present a brief review of the literature on the topic.

PubMed