Lupus vulgaris with a pseudo tumoral presentation, case report

Lupus vulgaris (LV) is a chronic, paucibacillary form of cutaneous tuberculosis. These often-mutilating lesions present a significant diagnostic challenge. We report the case of a 61-year-old patient who presented with a voluminous telangiectatic and ulcerated pseudo-tumoral mass measuring 10 cm in diameter, with a mutilating aspect. Histopathology of the skin lesion revealed granulomatous dermo-hypo dermatitis. Lymph node biopsy showed granulomatous inflammation. QuantiFERON-TB assay was positive, and the established diagnosis was pseudo-tumoral lupus vulgaris. The patient was successfully treated with standard four-drug anti-tuberculosis therapy. This case highlights the importance of a multidisciplinary approach, integrating rigorous clinical, biological, and histopathological correlation for early diagnosis. Appropriate anti-tubercular treatment led to significant and rapid lesion improvement, preventing severe and mutilating complications.