Novel Approaches To Cutaneous Tuberculosis In Pharmacy

Abstract

Cutaneous tuberculosis (CTB) is a rare extrapulmonary form of Mycobacterium tuberculosis infection manifesting in the skin. It can present with diverse clinical forms (e.g. lupus vulgaris, scrofuloderma, tuberculids) determined by infection route and host immunity. Conventional treatment follows standard anti-TB chemotherapy (2 months of isoniazid, rifampin, ethambutol, pyrazinamide followed by 4 months of isoniazid/rifampin). However, CTB poses diagnostic challenges (paucibacillary lesions often yield negative smears) and treatment issues (prolonged therapy, drug resistance). Recent pharmacy-oriented innovations are emerging: for example, macrophage-targeted polydopamine nanoparticles delivering rifampicin enable photothermal killing of M. tuberculosis in skin lesions; cationic nanoemulsion gels greatly enhance transdermal rifampicin penetration and efficacy against CTB; lipid nanovesicles (niosomes) encapsulating clofazimine and other TB drugs have been formulated for topical CTB therapy. Bio-inspired “cell-membrane-coated” nanocarriers (e.g. macrophage membrane nanoparticles) can evade immunity and home to infected sites. This review summarizes CTB pathology, current treatments, and novel pharmaceutical strategies – including advanced drug delivery systems, topical formulations, and immunotherapy – with comparative analysis (see Figures 1–5 and Tables 1–5). These innovative approaches aim to improve drug targeting, reduce toxicity, and overcome resistance in CTB management.