Lupus vulgaris

Last Updated: 2019-08-26

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

ICD11: -

Robert Willan (1757–1812).

  • Tuberculosis cutis luposa.

Most common form of skin tuberculosis.

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

Cutaneous Tbc infestation is caused by haematogenic, lymphogenic sowing or per continuitatem, but also by exogenous sowing.

  • localization
  • face, mammae, extremities and mucous membranes.
  • Primary afflorescence: erythematous-brownish, lentil-sized, partly serpiginous, partly confluent papules. Diascopically a apple jelly coloured nodule appears. It spreads peripherally. If the slight (!) speciality already breaks through the skin, one speaks of a positive probe phenomenon or mandrin phenomenon.
  • Often there is also pulmonary tuberculosis.

  • Clinic.
  • Tuberculin test (Mendel-Mantoux). 
  • Quantiferon test. 
  • Biopsy (both dermatopathological and microbiological examination).
  • Thorax X-ray or CT thorax.
  • Sonography of the abdomen and kidneys.
  • Collect sputum on 3 consecutive mornings (fasting up to 4 hours).
  • On 3 consecutive mornings, pass urine (fluid restriction the evening before!). 
  • Bronchoalveolar lavage (BAL).

Partially carcinomatous degeneration possible (carcinoma in lupo).

Chronic course.

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  7.  Pandhi D , Reddy BSN. Lupus Vulgaris Mimicking Lichen Simplex Chronicus. The Journal of Dermatology 2001;28:369-72. 
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