Open AccessLupus vulgaris and lichen scrofulosorum with disseminated tuberculosis
Author(s) -
N Okoh,
T Nnaji,
Chinwe Onyekonwu,
Chika Mary Emeka
Publication year - 2020
Publication title -
nigerian medical journal/nigerian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2229-774X
pISSN - 0300-1652
DOI - 10.4103/nmj.nmj_135_19
Subject(s) - lupus vulgaris , langhans giant cell , giant cell , medicine , tuberculosis , dermatology , pathology , histopathology , dermis , scars , systemic lupus erythematosus , tuberculin , disease
Cutaneous tuberculosis (CTB) represents only 1%-2% of extrapulmonary forms of tuberculosis (TB). CTB can present in the isolation or coexist with pulmonary and disseminated forms of TB. Pathologically confirmed lupus vulgaris (LV) coexisting with lichen scrofulosorum with disseminated TB is presented and discussed. A 12-year-old boy presented with 2 years history of slowly progressive facial plaque and multiple skin colored papules on the neck. Tuberculin skin test was positive with a reading of > 20 mm. Histopathology revealed ulcerated areas with impetiginisation and keratopurulent debris. The entire skin showed pseudoepitheliomatous hyperplasia with numerous granulomas in the superficial dermis consisting of Langhans-type multinucleated macrophages. Lesions responded to anti-tuberculosis therapy (ATT) with residual facial scar. LV and lichen scrofulosurum are two forms of CTB which rarely occurs together. This case is being presented to highlight the occurrence of this rare presentation and the need to institute ATT to prevent scarring.