Skin Disorders

Skin disorders cover a wide range of conditions, some benign, some very serious, and some even a sign of another underlying illness. A skin disorder not only affects your physical health, but also your emotional well-being.

Skin Care › Skin Disorders › Scrofula

Scrofula

Scrofula (Scrophula or Struma) refers to a variety of skin diseases; in particular, a form of tuberculosis , affecting the lymph nodes of the neck. In adults it is caused by Mycobacterium tuberculosis and in children by nontuberculous mycobacteria. The word comes from the Latin scrofulae , meaning brood sow. Scrofula has been known to afflict people since antiquity, and during the Middle Ages, the king's touch was thought to be curative. In modern times, surgery has played a pivotal role in the diagnosis and treatment of scrofula.

Causes of Scrofula

Infection with mycobacteria is usually caused by inhaling air contaminated by these organisms. The bacteria spread throughout the body, and may cause rubbery enlargement of the lymph nodes in the neck (cervical lymph nodes) as well as elsewhere. If these are not treated, the lymph nodes may become ulcerated, producing draining sores.

Signs and symptoms of Scrofula

Scrofula may be inherited or it may be acquired. It is most apt to develop in young persons, particularly in the case of children insufficiently nourished or living in dark or damp, unsanitary quarters. The most usual signs and symptoms are the appearance of a chronic, painless mass in the neck, which is persistent and usually grows with time. The mass is referred to as a "cold abscess", because there is no accompanying local calor or warmth and the overlying skin acquires a violaceous color. NTM infections do not show other notable constitutional symptoms, but scrofula caused by tuberculosis is usually accompanied by other symptoms of the disease, such as fever , chills , malaise and weight loss in ca. 43% of the patients. As the lesion progresses, skin becomes adhered to the mass and may rupture, forming a sinus and an open wound.

Treatment for Scrofula

When infection is caused by Mycobacterium tuberculosis , treatment is usually with 9 to 12 months of antibiotics. Several antibiotics need to be used at once, to avoid the bacterium becoming antibiotic-resistant. Common antibiotics for scrofula include:-

• INH
• rifampin
• pyrazinamide
• ethambutol

When infection is caused by mycobacteria other than Mycobacterium tuberculosis , as is often seen in children, therapy usually involves antibiotics, such as rifampin, ethambutol, and clarithromycin.

Surgery is seldom necessary, and is reserved for cases where medical therapy is only partially effective.