Frequency of Pulmonary Tuberculosis in Patients with Cutaneous Diseases taking Oral Steroid Therapy
DOI:
https://doi.org/10.61581/MJSP.VOL01/01/04Keywords:
Cutaneous diseases, systemic steroids, pulmonary tuberculosis, Mycobacterium, sputum smearAbstract
Objective: to investigate the frequency of pulmonary tuberculosis in patients of cutaneous diseases requiring high dose steroids therapy.
Methodology: Cross sectional study was conducted at Dermatology department of Nishtar Hospital Multan in one year duration from 2nd March 2018 to 2nd March 2019. Sixty patients currently diagnosed with skin manifestations and taking high dose steroids were screened for pulmonary tuberculosis. Patients were screened at 6 weeks, 3 months and 6 months. Chest radiograph, sputum smear for acid fast bacilli and sputum culture were performed at every visit. SPSS version 23 was used for analysis of data and test of significance.
Results: Sputum smear at 6 weeks, 3 months and 6 months was observed as 1.6%, 3.3% and 6.6%, respectively. Sputum culture at 6 weeks, 3 months and 6 months was observed as 11.6%, 13.3% and 10%, respectively. X-Ray at 6 weeks, 3 months and 6 months was observed as 1.6%, 0% and 0%, respectively.
Conclusion: Patients with cutaneous diseases taking systemic steroids should screen for pulmonary diseases at intervals because they can develop pulmonary tuberculosis.
Downloads
References
1. Butt G, Asad F, Khurshid K, Rani S, Pal SS. Frequency of pulmonary tuberculosis in patients with skin diseases requiring high dose long-term systemic steroid therapy. J Pak Associat Dermatol 2013;23 (2):126-132.
2. Tugal-Tutkun I, Pavesio C, De Cordoue A, Bernard-Poenaru O, Gül A. Use of Gevokizumab in Patients with Behçet’s Disease Uveitis: An International, Randomized, Double-Masked, Placebo-Controlled Study and Open-Label Extension Study. Ocul Immunol Inflamm. 2018;26(7):1023-33.
3. Beckert AK, Duthie EH. The Wrath of Steroids in Elderly Patients with Pulmonary Diseases. Curr Geri Rep 2016;5:p124.
4. Wong SH, Gao Q, Tsoi KK, Wu WK, Tam LS, Lee N et al. Effect of immunosuppressive therapy on interferon γ release assay for latent tuberculosis screening in patients with autoimmune diseases: a systematic review and meta-analysis. Thorax. 2016 ;71(1):64-72.
5. Youssef J, Novosad SA, Winthrop KL. Infection Risk and Safety of Corticosteroid Use. Rheum Dis Clin North Am. 2016;42(1):157-76.
6. Dalal AA, Duh MS, Gozalo L, Robitaille MN, Albers F, Yancey S et al. Dose-Response Relationship Between Long-Term Systemic Corticosteroid Use and Related Complications in Patients with Severe Asthma. J Manag Care Spec Pharm. 2016;22(7):833-47.
7. Matera MG, Cardaci V, Cazzola M, Rogliani P. Safety of inhaled corticosteroids for treating chronic obstructive pulmonary disease. Expert Opin Drug Saf. 2015;14(4):533-41.
8. Galván CA, Guarderas JC. Practical considerations for dysphonia caused by inhaled corticosteroids. Mayo Clin Proc 2012;87:901-4.
9. Krawiecka E, Szponar E. Tuberculosis of the oral cavity: an uncommon but still a live issue. Postepy Dermatol Alergol. 2015;32(4):302–306.
10. Romańska-Gocka K, Cieślińska C, Zegarska B. Pyoderma gangrenosum with monoclonal IgA gammopathy and pulmonary tuberculosis. Illustrative case and review. Postep Derm Alergol. 2015;32:137–41.
11. Sayarlioglu M, Inanc M, Kamali S. Tuberculosis in Turkish patients with systemic lupus erythematosus: increased frequency of extrapulmonary localization. Lupus. 2004;13:274-8.
12. Pal D, Behera D, Gupta D, Agarwal A. Tuberculosis in patients receiving prolonged treatment with oral corticosteroids for respiratory disorders. Indian J Tuberc. 2002;49: 83.
13. Kim H, Yoo C, Baek J et al. Mycobacterium tuberculosis infection in a corticosteroid-treated rheumatic disease patient population. Clin Exp Rheumatol. 1998;16:9-13.
14. Sasaki Y, Yamagishi F, Yagi T et al. A clinical study in the collagen disease patients developed pulmonary tuberculosis during corticosteroid administration. Kekkaku. 2000;75:569-73.
15. Kobashi Y, Yoneyama H, Okimoto N et al. Clinical analysis of pulmonary tuberculosis in association with corticosteroid therapy. Kekkaku 1999;74:789-95.
16. Dryga P, Nesterovskiĭ I, Kovalenko L, Elovskikh P. Clinical-morphological characteristics and prevention of steroid tuberculosis. Probl Tuberk Bolezn Leg. 1995;4:22-4.
17. Jick SS, Lieberman ES, Rahman MU, Choi HK. Glucocorticoid use, other associated factors, and the risk of tuberculosis. Arthritis Rheum. 2006;55:19- 26.
18. Chan YC, Yosipovitch G. Suggested guidelines for screening and management of tuberculosis in patients taking oral glucocortoids -- an important but often neglected issue. J Am Acad Dermatol. 2003;49:91-5.
19. Sayarlioglu M, Inanc M, Kamali S. Tuberculosis in Turkish patients with systemic lupus erythematosus: increased frequency of extrapulmonary localization. Lupus. 2004;13:274-8.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Muhammad Zulqarnain Haider Khan, Muhammad Shahid Nawaz Khan, Farah Sattar, Shamshad Akram, Esiha-Tir Razia, Asma Bano
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
