Atypical Orofacial Lupus Vulgaris in a Pediatric Patient: A Report of a Unique Case

Cutaneous tuberculosis represents only a small fraction of extrapulmonary tuberculosis; however, its consequences can be profoundly disfiguring when diagnosis is delayed. Among its clinical forms, lupus vulgaris is the most common morphological variant, but pediatric involvement of the nasal orifice with extension to the upper lip and intraoral mucosa remains distinctly rare. We report a remarkable case of a nine-year-old male patient with a three-year history of a slowly enlarging erythematous, crusted centrofacial plaque involving the nasal alae, columella, upper lip, and upper gingival mucosa, which was diagnostically challenging due to its unusual site. This case underscores how atypical orofacial lupus vulgaris may masquerade as other chronic granulomatous disorders and highlights the importance of early recognition to prevent progressive tissue destruction, cartilaginous damage, and permanent facial deformity.