Lupus Vulgaris Flashcards
Define
Chronic & progressive form of skin TB
More common in females
Who are susceptible individuals?
One with moderate immunity
And high degree of tuberculin sensitivity
Nidus of spread?
Pathways of spread?
Usually from cervical adenitis or pulmonary TB
Originates by hematogenous, lymphatics or contiguous spread from TB elsewhere in the body
Describe the lesion?
See image
Painful cutaneous skin lesion
With nodular appearance
Starts on nose, cheek → extends to adjacent areas → coalesce into erythematous plaques
On Diascopy?
Apple jelly nodules
Where are the lesions uncommon to be seen?
Trunk
Face & buttocks are common sites
Dx?
M. Prominent histopath feature?
+ve culture → M. TB/ M. Bovis
Prominent feature → formation of typical tubercles.
Treatment?
8 weeks → 4 drugs → INH, rifampicin, ethambutol, pyrazinamide
16 weeks 72 drugs → INH, rifampicin
Complication?
Secondary scarring
Squamous Cell carcinoma can develop within plaques
Name the dis → cutaneous TB.
Lupus vulgaris
Scrofuladerma
Tuberculosis verrucosa cutis
Tuberculosis cutis orificialis
Lichen scrofulosorum
Define scrofuloderma?
Subset. TB leading to cold abscess formation → secondary breakdown of overlying skin
Occurs from contiguous involvement of skin over another tuberculous lymphadenitis, TB of bones & joints or tuberculous epididymitis
What is tuberculosis verrucosa cutis?
Caused by accidental inoculation of TB bacilli
In previously sensitized individuals with high immunity
TB cutis orificialis
Cutis → involves skin
Orificialis → involves mucosa
Eg. → oral mucosa: pulmonary TB
anal region: GI TB
urogenital mucosa → in renal TB
Lichen scrofulosorum?
A/w → chronic tuberculous dis of LNs, bones OR with specific pleurisy
→ seen post BCG vaccination
→ a/w: M. Avium intracellulare infections
