Lupus vulgaris developing at the site of misdiagnosed scrofuloderma

J Eur Acad Dermatol Venereol. 2003 May;17(3):313-5. doi: 10.1046/j.1468-3083.2003.00783.x.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • DNA, Bacterial / genetics
  • Diagnosis, Differential
  • Female
  • Humans
  • Lupus Vulgaris / diagnosis*
  • Lupus Vulgaris / drug therapy
  • Lupus Vulgaris / pathology
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification
  • Neck
  • Polymerase Chain Reaction
  • Tuberculosis, Cutaneous / diagnosis

Substances

  • Antitubercular Agents
  • DNA, Bacterial