Development of chancre-variant cutaneous tuberculosis after BCG vaccine administration in a patient with migraines.

Recently, the Bacillus Calmette-Guérin (BCG) vaccine has gained popularity as a speculated therapy for autoimmune and inflammatory disorders. It also remains the most widely distributed vaccination because of its role in tuberculosis prevention in pediatric populations. While 95% of recipients should expect common skin complications with the administration of this vaccine, other more serious cutaneous sequelae could develop from this vaccine. In this brief report, we highlight a adult patient who had developed cutaneous tuberculosis, specifically tuberculosis chancre, secondary to the BCG vaccine as a possible treatment for migraines. After advanced wound care and medical treatment for tuberculosis, the patient’s skin ulceration eventually healed with minimal evidence of prior infection. Cutaneous tuberculosis, in of itself, is exceedingly rare, with the chancre-variant accounting for 1% of diagnosed cases. While it is considered common in pediatric populations, the chancre variant of cutaneous tuberculosis is not typically seen in adult populations. As the BCG vaccine becomes more popular in the therapy of other medical conditions, severe dermatologic sequelae from the vaccine necessitating advanced wound care may become more prevalent. Therefore, it is imperative that healthcare providers, especially wound care providers, recognize potentially severe side-effects associated with its use, how to best manage patients that may develop serious adverse events and how variants of cutaneous tuberculosis may appear clinically.