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Introduction: Finger cutaneus tuberculosis is rare and difficult to diagnosis. It is diffıcult to detect tuberculosis bacilli at skin biopsy and culture. We present cutaneus tuberculosıs in the finger diagnosed with regional lymph node biopsy.
Case Presentation: The patient is a 37 year-old female working to be secretary in a hospital. She admitted to the dermatology policlinic complaing with swelling and pain in her left ringer finger. The lesion was evaluated to be paronychia. It was given systemic and topical antibiotics. Although the patient regularly used the treatment, the lesion didn’t healed, erythema and edema increased and abscess was formed. Abscess was evacuated. The pathological finding was’nt detected in the abscess cultures (nonspecific, tuberculosis and mushrooms cultures). There wasn’t pathology in serologic tests. The chest x- ray was normal, PPD was 16 mm with one BCG scar. The finger bone lesion wasn’t detected in magnetic resonance imaging. Cat-Stratch Disease was suspected and started azithromycin treatment. The lesion of the patient didn’t improved. Later her left elbow region occured swelling, erythema and severe pain. It was performed biopsy from her elbow lymph node. The result of biopsy was granulamatosis inflammation with caseous necrosis. There wasn’t the tuberculosis at family contact examination except her grand father had pulmoner tuberculosis 10 years ago. Then she didn’t used prevented treatment. The patient was started anti tuberculosis treatment. The patient received 6 months anti tuberculosis drugs (2 months of HRZE plus 4 months of HR) (H: isovıt, R: rifampine, Z:pırazinamide, E: etambutol). Her finger improved
Conclusion: Finger cutaneus tuberculosis is a rare form of tuberculosis. We must be consider tuberculosis except other diaseas when there is swelling, erytema and abscess formation on the finger. We must control the regional lymph node at the region of lesion for the diagnosis.