Indolent non-caseating Mycobacterial tuberculosis.

At the present time, tuberculosis affecting the skin or the small bones of the hands and feet is uncommon in Great Britain. Out of 2500 cases of tuberculosis in children documented by Miller, Seal, and Taylor (1963), 34 had a primary skin infection and 28 had a haematogenous skin infection. Of these 28, only 6 were of the verrucous type. In their entire series they saw only 2 cases of tuberculosis of the phalanges, and these presented as painless, spindle-shaped swelling of the affected phalanx with underlying radiologically detectable bone changes. The child here described embodied clinical features of both these rare types, and the case raises some interesting questions.