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Summary
Multiple Bacillus Calmette-Guérin (BCG) vaccinations can increase the risk of developing lupus vulgaris, a rare skin complication. This case highlights successful treatment with rifampin for this persistent condition.
Area of Science:
- Dermatology
- Infectious Diseases
- Vaccinology
Background:
- Intradermal Bacillus Calmette-Guérin (BCG) vaccination is a common method for preventing tuberculosis.
- Cutaneous complications following BCG vaccination are rare but can occur.
- Lupus vulgaris is a chronic form of cutaneous tuberculosis.
Observation:
- A patient developed a lupus-like skin condition, identified as lupus vulgaris, over 30 years after receiving two intradermal BCG vaccinations at the affected site.
- Skin biopsy confirmed lupus vulgaris, although acid-fast stains and cultures from the lesion were negative.
- The incidence of BCG-induced lupus vulgaris appears higher with multiple vaccinations compared to single vaccinations.
Findings:
- The case presented is a rare, long-term complication of intradermal BCG vaccination.
- Histopathological examination of the skin biopsy was characteristic of lupus vulgaris.
- Despite negative microbiological tests from the lesion, the clinical presentation and history strongly suggested BCG-induced lupus vulgaris.
Implications:
- This case underscores the importance of considering BCG vaccination history in the differential diagnosis of chronic cutaneous lesions.
- Multiple BCG vaccinations may represent a risk factor for developing lupus vulgaris.
- Rifampin demonstrated efficacy in treating this long-standing case of lupus vulgaris, suggesting its utility in managing BCG-induced cutaneous tuberculosis.