The mode of infection is thought to be exogenous or endogenous inoculation following minor trauma including tattooing [16,17] and ear piercing [18]. The clinical presentation also varies with the geographic location. Â, Khandpur S, Nanda S, Reddy BS (2001) An unusual episode of lupus vulgaris masquerading as sporotrichosis. Archives of Disease in Childhood 2018;103:71-72. http://dx.doi.org/10.1136/archdischild-2016-312338, Bravo FG, Gotuzzo E. Cutaneous tuberculosis. Occasionally the granulomas may be sarcoidal or mixed. Lupus vulgaris is characterized by a macule or papule, with a brownish-red color and soft consistency that form larger plaques by peripheral enlargement and coalescence 20). The many faces of tuberculosis of the oral mucosa- Three cases with distinct pathomechanisms. Lupus vulgaris: 30 years of experience from eastern Turkey. Sunlight. Â, Kiehl P, Eicher U, Vakilzadeh F (1992) A lupus-vulgaris like atypical mycobacteriosis caused by Mycobacterium xenopi (lupus xenopi). When the face is severely disfigured or large areas of the skin are necrotic, surgical excision of the affected areas may be recommended. Currently, though PCR appears to be the most useful in multibacillary forms of CTB, its utility in the paucibacillary forms like LV is limited [54]. After it attains a certain size it may continue to persist in the same condition indefinitely and may eventually resolve after leaving a cicatrix which is depressed. Int J Tuberc Lung Dis. Mycobacterial infection. Cutaneous tuberculosis (lupus vulgaris). The clinician must be aware that multiple forms of TB can occur concomitantly in such situations and the patient must be investigated and treated accordingly [53]. LV mimics various other tropical dermatoses and can often be misdiagnosed clinically as TBVC, leishmaniasis, Hansen’s disease, syphilis and deep fungal infections e.g. [20] described four major types of lupus vulgaris: Figure 1. 2002;3:319–28. Â, Reznik IE (1967) Lupus tuberculosis of the larynx in a child. Concomitant active TB elsewhere involving the lungs, bones, liver and other organs can be demonstrated in only 10% to 30% of the cases, and approximately only one half of the cases have history of past infection [46]. The lesions are covered with thick silvery scales resembling psoriasis. Multiple therapies may be needed, and in such patients, directly observed treatment (DOT) is recommended. Nodular lupus vulgaris on the retroauricular area, Figure 3. This gives rise to a protuberant or elevated mass and this is called hypertrophic lupus. 1771–2. ). It begins as painless reddish-brown nodules which slowly enlarge to form irregularly shaped red plaque. (B) The lesion healed with hypopigmented, atrophic scarring at the end of the 6 months of treatment. Erythematous type: Erythematous plaques of 2-5 cm with irregular margins with minimal scaling on the surface, clinically resembling eczema. Though lupus vulgaris is uncommon in the immunocompromised host, both solitary and disseminated lesions have been reported. The diagnosis of LV requires a full workup including a detailed history and a thorough physical examination. Of the seventy-one patients with cutaneous tuberculosis, 39 had lupus vulgaris and 32 with TBVC. Lupus vulgaris (also known as tuberculosis luposa[1]) are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around the nose, eyelids, lips, cheeks, ears[2] and neck. In 1903, Niels Ryberg Finsen was awarded the Nobel Prize for his invention of light therapy for skin tuberculosis (lupus vulgaris). The term “lupus” is used to refer to the skin ulceration and necrosis that occurs when it is left untreated. Dermatol Clin. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. The high incidence of lupus vulgaris on the legs in Indian children had been explained by the re-inoculation of tuberculosis bacilli through minor trauma or infection, especially during squatting 7). Lupus vulgaris is a painful nodular skin condition most commonly caused by the microorganism mycobacterium tuberculosis.It usually affects the face, or the buttocks and trunk.

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