Lupus vulgaris reported in 2 cases

Abstract

Introduction: Cutaneous tuberculosis is a group of polymorphous and varied manifestations of the skin and mucous membranes, produced by infection with some species of Mycobacterium tuberculosis complex. The specific primary lesion is the lupoma, sometimes evolving into mutilating forms. Purpose: Lupus vulgaris particularities reported in two clinical cases. Material and methods: A 68-year-old female, presented for multiple infiltrative, prominent erythematous plaques and placards with various diameter, well contoured by a violaceus halo, with irregular contour on the trunk. A 6-year-old boy presented for brownish-red, soft papules with smooth surface on the face and trunk. The lesions appeared 3 years ago; and 6 months ago after a minor trauma injury, the lesions have spread. Results: Chest X-ray didn’t reveal any abnormalities. During dermascopy the sign of “apple jelly” was found positive. Histopathological exam found caseous necrosis, tuberculoid granulomas composed of epithelioid cells and Langhans giant cells, surrounded by mononuclear and a dense lymphocyte infiltrate localized in the dermis. Mantoux probe was 17 mm in diameter. Clinical examination sustained by the histopathological exam and Mantoux probe inferred the diagnosis of lupus vulgaris (tuberculosis). Conclusions: The particularities of the presented cases with distinct clinical signs, the histopathological presence of granulomatous inflammation with specific cellular appearance, the hyperergic Mantoux test and the lack of characteristic pulmonary changes represent a casuistic interest of lupus vulgaris.