Lichen scrophulosorum

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: EA5Y

Hebra 1860.

Tuberculosis cutis lichenoides.

In the context of a TB infection, lichenoid papules occur in a hyperergic immune state.

In particular, occurring in childhood and adolescence.

Strong immune reaction in the context of a TB infection.

  • Symmetrically, perifollicularly and follicularly arranged, yellow-brown, erythematous papules.

  • History.
  • Clinical.
  • Tuberculin test (Mendel-Mantoux). 
  • Quantiferon test.
  • Biopsy.
  • To exclude systemic involvement:
  • Thoracic X-ray or CT- thorax.
  • Sonography of abdomen and kidneys.
  • In the morning (fasting up to 4h) on 3 consecutive days, sputum must be collected.
  • Pass urine in the morning on 3 consecutive days (fluid restriction the evening before!).
  • Bronchoalveolar lavage (BAL).

  • Especially on the lateral trunk.

Tuberculoid structures, Langhans giant cells, necrosis. 

  • Spontaneous healing within weeks.
  • Ggl. recurrences.

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  2.  Joshi HS, Zacharia A , Warrier A. Lichen scrofulosorum. BMJ Case Rep 2014;2014. 
  3.  Patra S, Patro B, Patel R, Aneja S , Sarkar D. Lichen scrofulosorum presenting as pyrexia of unknown origin. J Coll Physicians Surg Pak 2014;24:141-2. 
  4.  Singal A , Pandhi D. Lichen scrofulosorum and endometrial tuberculosis: a novel association. Int J Dermatol 2016;55:322-4. 
  5.  Tobita R, Sumikawa Y, Imaoka K, Murata S, Dekio I, Maruyama R et al. Lichen scrofulosorum caused by pulmonary Mycobacterium avium complex (MAC) infection. Eur J Dermatol 2011;21:619-20.