Lupus vulgaris

Last Updated: 2023-07-07

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

ICD11: 1B12.8

Robert Willan (1757-1812).

  • Tuberculosis cutis luposa.

The most common form of cutaneous tuberculosis.

  • Women are affected twice as often.
  • Rarely occurring, but still the most common form of cutaneous tuberculosis.
  • Independent of age.

Cutaneous TB infection occurs by haematogenous, lymphogenous seeding or per continuitatem, but can also occur exogenously.

  • Localisation
  • Face, mammae, extremities and mucous membranes.
  • Primary florescence: erythematous-brownish, lenticular, partly serpiginous, partly confluent papules. Diascopically, an apple jelly-coloured nodule is seen. It spreads to the periphery. If one breaks through the skin with the light! If the mild papule breaks through the skin, it is called a positive probe phenomenon or stylet phenomenon.
  • Frequently, there is also pulmonary tuberculosis.

  • Clinic.
  • Tuberculin test (Mendel-Mantoux).
  • Quantiferon test.
  • Biopsy (both dermatopathological and microbiological examination).
  • Thoracic X-ray or CT- chest.
  • Sonography of abdomen and kidneys.
  • Collect sputum on 3 consecutive mornings (fasting up to 4h).
  • Pass urine on 3 consecutive mornings (fluid restriction the night before!).
  • Bronchoalveolar lavage (BAL).

Partially carcinomatous degeneration possible (carcinoma in lupo).

Chronic progression.

  1. Barbagallo J, Tager P, Ingleton R, Hirsch RJ , Weinberg JM. Cutaneous tuberculosis: diagnosis and treatment. Am J Clin Dermatol 2002;3:319-28. 
  2.  Diallo R, Frevel T, Poremba C, Cirkel U, Metze D , Dockhorn-Dworniczak B. Lupus vulgaris als Ursache einer tuberkulösen Mastitis. Der Pathologe 1997;18:67-70. 
  3.  Ghorpade A. Lupus vulgaris over a tattoo mark - inoculation tuberculosis. Journal of the European Academy of Dermatology and Venereology 2003;17:569-71. 
  4.  Gooptu, Marks, Thomas , James. Squamous cell carcinoma associated with lupus vulgaris. Clin Exp Dermatol 1998;23:99-102. 
  5.  Margolis DJ, Hoffstad O , Bilker W. Association or lack of association between tetracycline class antibiotics used for Akne vulgaris and lupus erythematosus. Br J Dermatol 2007;157:540-6. 
  6.  Motta A, Feliciani C, Toto P, De Benedetto A, Morelli F , Tulli A. Lupus vulgaris developing at the site of misdiagnosed scrofuloderma. Journal of the European Academy of Dermatology and Venereology 2003;17:313-5. 
  7.  Pandhi D , Reddy BSN. Lupus Vulgaris Mimicking Lichen Simplex Chronicus. The Journal of Dermatology 2001;28:369-72. 
  8.  Senol M, Ozcan A, Mizrak B, Turgut AC, Karaca S , Kocer H. A Case of Lupus Vulgaris with Unusual Location. The Journal of Dermatology 2003;30:566-9.Â