Lupus vulgaris developing at the site of misdiagnosed scrofuloderma

✍ Scribed by A Motta; C Feliciani; P Toto; A De Benedetto; F Morelli; A Tulli

• Book ID: 104470359
• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 110 KB
• Volume: 17
• Category: Article
• ISSN: 0926-9959
• DOI: 10.1046/j.1468-3083.2003.00783.x

✦ Synopsis

ABSTRACT

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis primarily occurring in developing countries. The recent increase in the incidence of tuberculosis, especially due to human immunodeficiency virus (HIV) infections, has led to a resurgence of extrapulmonary forms of this disease. We describe a case of lupus vulgaris in a 33‐year‐old woman who had a 5‐year history of a slowly growing plaque on her neck. The lesion was located at the site of surgery repairing the scar resulting from the incision of a subcutaneous abscess during childhood. This lesion was misdiagnosed as bacterial abscess. Histopathologic examination of the plaque revealed non‐caseating tuberculoid granulomas consisting of lymphocytes, epithelioid and giant cells. Staining for acid‐fast bacilli and culture from biopsied tissue was negative. Polymerase chain reaction (PCR) for detection of Mycobacterium tuberculosis DNA, performed on a skin biopsy specimen, was positive. A diagnosis of lupus vulgaris developing at the site of a previous misdiagnosed scrofuloderma was made. Conventional antitubercular therapy with rifampicin, isoniazid and ethambutol was administered for 6 months, resulting in resolution of the lesion.