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Lupus vulgaris: unusual presentation on face
Indian Journal of Leprosy
|January 17, 2015
Summary
Early diagnosis of lupus vulgaris, a disfiguring skin tuberculosis variant, is crucial. Prompt identification prevents severe scarring and deformity, emphasizing the need for clinical vigilance and timely biopsies.
Area of Science:
- Dermatology
- Infectious Diseases
- Pathology
Background:
- Lupus vulgaris is a rare cutaneous manifestation of tuberculosis.
- Untreated lupus vulgaris can lead to significant disfigurement and mutilation.
- Early diagnosis is critical to prevent irreversible damage.
Observation:
- A 28-year-old female presented with a progressive annular plaque on her cheek, accompanied by satellite lesions.
- Diascopy revealed characteristic apple jelly nodules.
- No regional lymphadenopathy was noted.
Findings:
- Histopathological examination confirmed lupus vulgaris with granulomas, epithelioid cells, Langhans' giant cells, lymphocytic infiltration, and focal necrosis.
- The findings were consistent with cutaneous tuberculosis.
Implications:
- Delayed diagnosis of lupus vulgaris can result in necrosis and destruction of underlying bone and cartilage.
- Clinicians must maintain a high index of suspicion for atypical presentations.
- Biopsy for histological and bacteriological studies is vital for accurate diagnosis and management.
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