Cutaneous tuberculosis (TB) can be caused by M. tuberculosis, M. bovis, and the Bacillus Calmette–Guérin (BCG) vaccine. The disease has diverse clinical features that can follow immune-mediated processes or endogenous and exogenous spread of the microorganism. The exogenous spread is less common. Even though cutaneous TB comprises less than 1% of all TB cases, it is important to consider it when a clinical picture suggestive of it is found [1]. Exogenous inoculation develops after M. tuberculosis is directly inoculated into the skin of an individual susceptible to the infection. This results in tuberculosis verrucosa cutis (TVC), TB chancre, and in some cases lupus vulgaris (LV). Endogenous spread occurs in previously infected cases by means of contiguous extension, hematogenous dissemination or through lymphatic circulation or in old scars of scrofuloderma [2]. Hematogenous spread is observed in LV, acute miliary TB, papulonecrotic tuberculoid (PNT), and metastatic TB abscess (gummatous TB). A contiguous extension can be seen in orificial TB and scrofuloderma.

LV is the most common type of cutaneous TB and affects females 2 to 3 times more often than males. It is chronic and progressive.The lesions of LV are commonly found in the region of the head and neck [3] and are generally solitary, small, sharply defined, nodular, reddish brown, with a gelatinous consistency (apple jelly nodules). In western countries, these lesions usually appear on the head and neck while in tropical or subtropical regions they develop on lower extremities and the buttocks.

The existing clinical variations are as follows:

• Classic plaque
• Keratotic
• Hypertrophic
• Ulcerative
• Vegetating

The classic plaques begin as discrete red-brown papules. They coalesce and form soft and gelatinous (apple-jelly) plaques with central atrophy and elevated verrucas border.

Persistent lesions become ulcerated and damage the underlying structures leading to disfigurement and have an increased risk of malignant transformation.

• Pain

  Lupus vulgaris (also known as Tuberculosis luposa) are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around nose, eyelids, lips, cheeks, ears and neck. [diki.pl]

  Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most medical Definition of lupus vulgaris. : a tuberculous disease of the skin marked by formation [nsxmj.co]

  Advanced Search: • Use “ “ for phrases o [ “pediatric abdominal pain” ] • Use – to remove results with certain terms o [ “abdominal pain” –pediatric ] • Use OR to account for alternate terms o [teenager OR adolescent ] [msdmanuals.com]

  Summarize this article for a 10 years old SHOW ALL QUESTIONS Lupus vulgaris (also known as tuberculosis luposa[1]) are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around the nose, eyelids, lips, cheeks, [wikiwand.com]

• Fever

  A 21-year-old Brazilian man presented with a two-month history of asymptomatic cutaneous lesions accompanied by fever and fatigue. [ncbi.nlm.nih.gov]

  Definitions of lupus vulgaris 1 n tuberculosis of the skin; appears first on the face and heals slowly leaving deep scars Type of: T.B., TB, tuberculosis infection transmitted by inhalation or ingestion of tubercle bacilli and manifested in fever and [vocabulary.com]

  She also had low grade fever and significant weight loss. The nodules appeared on the forearm three months back and progressively spread towards the hand. [ispub.com]

  [Figure - 1] As the patient was having fever, cough and weight loss he was referred to chest specialist for further examination and to exclude pulmonary tuberculosis. Investigations revealed raised ESR. [ijdvl.com]

• Inflammation

  Abstract Tuberculosis and leprosy are chronic mycobacterial infections that elicit granulomatous inflammation. [nepjol.info]

  While corticosteroids are a common treatment for lupus-related inflammation, they can interfere with insulin production. [lupusresearch.org]

  SIBO is associated with intestinal inflammation but not increased permeability or systemic inflammation. 相关会议推荐 2016（第二届）肠道微生物组与临床应用研讨会 会议时间：2016.04.15-2016.04.16 会议地点：上海 会议详情： http://www.bioon.com/z/2016MicIntestinal/Index.shtml [news.bioon.com]

  Msida, Malta Correspondence to Dr Elaine Pace Spadaro, Department of Child & Adolescent Health, Mater Dei Hospital, Tal-Qroqq, Msida MSD2090, Malta; elaine.pace-spadaro{at}gov.mt Statistics from Altmetric.com BCG vaccine lupus vulgaris granulomatous-inflammation [adc.bmj.com]

• Weight Loss

  There was now a history of malaise, fever, dry cough, and anorexia and weight loss for the past 2 months. The patient was fully vaccinated in childhood, including against varicella infection. [ncbi.nlm.nih.gov]

  She also had low grade fever and significant weight loss. The nodules appeared on the forearm three months back and progressively spread towards the hand. [ispub.com]

  DOI: 10.3238/arztebl.2018.0428a ; Grohé, C; Tronnier, M Article Figures & Tables Metrics Figure Tuberculosis Cutis Luposa (Lupus Vulgaris) An 83-year-old man complained of lessened performance ability, weight loss, and febrile episodes of several months [aerzteblatt.de]

  There was no history of weight loss, fever, cough, diabetes and hypertension. There was a history of treatment for primary pulmonary tuberculosis 5 years previously. [smjonline.org]

  She had no history of fever/weight loss/cough, piercing/tattooing, trauma, or surgical procedure done at site of lesion. Personal and family history of tuberculosis (TB) or contact with TB patient was absent. [ijpmonline.org]

• Swelling

  Clinical and external examination showed an irregular, firm, ulcerative swelling measuring 6 cm x 4 cm x 1 cm. The swelling was raised from the surface and had ill-defined margins. [ijpmonline.org]

  She had suffered from swellings over sides of neck 15 years ago for which some drugs were taken for 2-3 months. She gave history of loss of weight of about 10 kg over the past one year, however she denied history of fever or chronic cough. [ijdvl.com]

  The problem started as a solitary painless eruption over the coronal sulcus, and in 2 months the lesions changed into multiple, painless small ulcers followed by the development of inguinal swellings. [arizona.pure.elsevier.com]

  The swelling had been present for 6 months and was increasing in size. An X-ray showed an enlarged right first metacarpal containing lytic and sclerotic areas suggestive of chronic osteomyelitis (figure 1A). [adc.bmj.com]

  Cutaneous Rosai Dorfman disease: presenting as massive bilateral eyelid swelling. Pediatr Dermatol. 2009;26:633-5. [ Links ] 5 Toledo del Castillo B, Mata-Fernández C, Rodríguez Soria VJ, Parra Blanco V, Loughlin G, Campos-Domínguez M. [scielo.br]

• Dyspnea

  She had presented with dyspnea and lupus vulgaris was suspected after general examination. [ncbi.nlm.nih.gov]

• Nausea

  Common side effects of Minocin include: nausea,; vomiting,; upset stomach, Minocycline acne success stories | Acne …18 Nov 2017 I was recommended with minocycline pills. It is a great acne therapy. [fitnesshipster.com]

  […] problems, including rashes and tiny red spots fatigue fever painful or swollen joints weight loss sun sensitivity mouth ulcers anemia, or low red blood cell count leukopenia, or low white blood cell count chest pain headaches vision problems abdominal pain nausea [medicalnewstoday.com]

  Other symptoms depend on which part of the body is affected: Brain and nervous system: Headaches, numbness, tingling, seizures, vision problems, and personality changes Digestive tract: Abdominal pain, nausea, and vomiting Heart: Valve problems, inflammation [medlineplus.gov]

  The minor problems are nausea, loss of appetite, and red urine. The major problems are hepatitis, peripheral neuropathy, and ocular problems, especially with ethambutol. [clinicaladvisor.com]

• Vomiting

  Repeated, heavy vomiting. Lethargy, confusion, and headaches. 41. [medicalnewstoday.com]

  Other symptoms depend on which part of the body is affected: Brain and nervous system: Headaches, numbness, tingling, seizures, vision problems, and personality changes Digestive tract: Abdominal pain, nausea, and vomiting Heart: Valve problems, inflammation [medlineplus.gov]

  Common side effects of Minocin include: nausea,; vomiting,; upset stomach, Minocycline acne success stories | Acne …18 Nov 2017 I was recommended with minocycline pills. It is a great acne therapy. [fitnesshipster.com]

  Manifestations may include abdominal pain resulting from serositis, nausea, vomiting, manifestations of bowel perforation, and pseudo-obstruction. SLE rarely causes parenchymal liver disease. [merckmanuals.com]

• Jaundice

  Hench (1896-1965) had already observed that some arthritic patients could experience a temporary remission of their symptoms during pregnancy or coinciding with jaundice. [sfhd.chez.com]

  jaundice! and more!—are terrifying on paper. Sure, they're just side effects, not guaranteed reactions, but it was more than enough for me to file it under Not An Option. To be fair, my acne situation was fairly tame, a smattering 348034 [fitnesshipster.com]

• Ulcer

  Physical examination revealed ulceration with crusting involving the entire helical margin and lobule of the right pinna. The ulcers were covered with blood clots and crusts. [indianjotol.org]

  Secondary to ulcerations, cicatrices, and complications emerging during the progression of the disease, lupus vulgaris can manifest in diverse clinical forms; 1) plaque or planar form, 2) ulcerative or mutilant form, 3) vegetant form, 4) tumor-like form [ncbi.nlm.nih.gov]

  Ziehl-Neelsen staining of discharge from the ulcers showed numerous acid fast bacilli (AFB). [smjonline.org]

  The apple-jelly nodules revealed by diascopy are highly characteristic; finding them may be decisive, especially in ulcerated, crusted, or hyperkeratotic lesions. [epathologies.com]

• Skin Lesion

  Lupus vulgaris can be mimicked by several other skin conditions, and a 69-y-old female is described with an extremely long history of extensive infiltrative skin lesions with abundant scaling. [ncbi.nlm.nih.gov]

  Skin biopsies from the center and from the border of the lesion showed an unaffected epidermis with some parakeratosis. [link.springer.com]

  Marked improvement in the skin lesion was also noted after initiation of triple antituberculous therapy. [paojournal.com]

• Papule

  These papules enlarge to plaques, develop into granulomatous, crusted ulcers, which are as similar as cutaneous lesions of lupus vulgaris. Herein, we report a patient with lupoid CL mimicking lupus vulgaris [authorea.com]

  It was comprised of multiple shiny nontender soft papules arranged in annular configuration. [ncbi.nlm.nih.gov]

  The initial lesion is a brownish-red, soft or friable lupus macule or papule with a smooth surface or covered by a scale. On diascopy the infiltrate exhibits a typical apple-jelly color. [epathologies.com]

  Polymerase chain reaction for Mycobacterium tuberculosis in both the left helix plaque and the thigh papule was negative. [journals.lww.com]

  (c) Erythematous scaly papules over the posterior hairline extending up to the nape of the neck. [ejdv.eg.net]

• Erythema

  Differential Diagnosis (Other conditions with similar appearance) Bowen Disease Papulonecrotic Tuberculids Catscratch disease Pityriasis lichenoides Dermatitis Herpetiformis Pseudolymphoma, Cutaneous Endemic Syphilis Psoriasis, Pustular Erythema induratum [ozarkderm.com]

  Fig. 52 Erythema induratum Fig. 53. Erythema induratum - Suppurative granuloma: Fig. 52 Erythema induratum Fig. 53. Erythema induratum Kaikki kappaleet Noitasapatti Kuolon Kultin Kaljat Lupus vulgaris Juhannuspsykoosi (2016) Ouija... [picsearch.com]

  Code L52 Erythema nodosum 2016 2017 2018 2019 Billable/Specific Code Type 1 Excludes tuberculous erythema nodosum ( A18.4 ) tuberculous A18.4 nodosum L52 ICD-10-CM Diagnosis Code L52 Erythema nodosum 2016 2017 2018 2019 Billable/Specific Code Type 1 [icd10data.com]

  At the 2-week telephonic follow-up, most erythemas and scales on both earlobes had regressed. [journals.lww.com]

• Skin Disease

  The term "lupus" to describe an ulcerative skin disease dates to the late thirteenth century, though it was not until the mid-nineteenth that two specific skin diseases were classified as Lupus erythematosus and Lupus vulgaris. [diki.pl]

  Skin and Connective Tissue Diseases Skin Diseases Skin Diseases, Infectious Skin Diseases, Bacterial Tuberculosis, Cutaneous Diseases Bacterial Infections and Mycoses Infection Skin Diseases, Infectious Skin Diseases, Bacterial Tuberculosis, Cutaneous [hon.ch]

  These findings are repetitively reported as suggestive for granulomatous skin diseases such as sarcoidosis, tuberculosis, and granuloma annulare. [hindawi.com]

• Anger

  These can include stress, sadness, anxiety and anger. Many parents, caregivers and siblings also experience emotional challenges. It is important to recognize these feelings and provide time to talk about them. [rheumatology.org]

• Malar Rash

  Malar Rash About half of people with lupus experience a characteristic red “malar” rash or color change that may appear across the cheeks and bridge of the nose in the shape of a butterfly. [lupusresearch.org]

  Some people with lupus have a red rash over their cheeks and the bridge of their nose -- called a "butterfly" or malar rash. Hair loss and mouth sores are also common. [webmd.com]

  Rashes: butterfly-shaped rash over the cheeks - referred to as malar rash red rash with raised round or oval patches - known as discoid rash rash on skin exposed to the sun Mouth sores: sores in the mouth or nose lasting from a few days to more than a [rheumatology.org]

  Systemic lupus erythematosus Share on Pinterest A malar rash is a key symptom of lupus. Image credit: Doktorinternet, 2013. SLE is the most familiar type of lupus. It is a systemic condition. This means it has an impact throughout the body. [medicalnewstoday.com]

  rash (malar discoid rash not counted), bullous lupus, toxic epidermal necrolysis variant of SLE, maculopapular lupus rash, photosensitive lupus rash (in the absence of dermatomyositis) or Subacute cutaneous lupus (nonindurated psoriaform and/or annular [merckmanuals.com]

• Facial Ulceration

  This delay could have been averted if there was a high index of clinical suspicion especially with her unexplained and progressive ulcerated and nodular facial lesions. [ispub.com]

• Irritability

  This effect is quite different from the irritations or bums produced by heat rays. [nobelprize.org]

  Symptoms vary but can include: skin that appears black or dead irritation, burning, or redness in the affected area numbness and pain 43. [medicalnewstoday.com]

  This product is contraindicated in patients with a history of hypersensitivity to products containing, lincomycin, benzoyl peroxide or any other cheap viagra online component ofIf irritation becomes severe, discontinue use; if irritation still continues [tacomanarrowshalf.com]

  […] múltiple A02 Escalofríos A03 Fiebre A04 Astenia/cansancio/debilidad A05 Sensación de enfermedad A06 Desmayo/síncope A07 Coma A08 Inflamación A09 Problemas de sudoración A10 Sangrado/hemorragia NE A11 Dolor torácico NE A13 Miedo al tratamiento A16 Lactante irritable [iqb.es]

The diagnosis of LV can be a challenging task as the skin changes are atypical and there is a paucity of TB bacilli in the lesions.

Skin biopsy and histology may show tubercules or tuberculoid granulomas without caseation in the papillary dermis with few or no bacilli, and variable epidermal hyperplasia [4] [5]. If a superficial biopsy is obtained then pseudo-epithelial hyperplasia with a non-specific inflammatory cell infiltrate may be observed, missing the features of LV [6].

Identification of Mycobacteria is essential for the definitive diagnosis of cutaneous TB but this is usually impossible since there are few bacilli. M. tuberculosis rarely grows on culture when the sample is taken from a patient with high levels of immunity or from chronic lesions.

Special tests like the polymerase chain reaction (PCR) can be performed to confirm the diagnosis or when the histopathological findings are not characteristic of the condition [7].

Ziehl-Neelsen staining and PCR may also give negative results in LV due to the paucity of TB bacilli [8] [9].

Diagnosis relies heavily on clinical features, histopathological findings, a positive purified protein derivative test (PPD) and response to anti-TB medication [2] [10].

The differential diagnosis of cutaneous TB includes leprosy, leishmaniasis, syphilis, actinomycosis, and deep mycosis.

• Skin Test Positive

  In addition, men are more likely than women to have a positive tuberculin skin test result. The reason for these differences may be social, rather than biologic, in nature. [emedicine.com]

• Granulomatous Tissue

  CLINICAL FEATURES The skin covering the inflamed lymph nodes becomes indurated, purplish in color followed by ulceration with crusty ,irregular pale granulomatous tissue ending in scarring. [drmhijazy.com]

Treatment *Treatment generally consists of the administration of antitubercular medications *In some cases, removal of lesions is recommended Treatment of lupus vulgaris typically consists of the administration of antitubercular medications, usually combinations [ozarkderm.com]

We report a case of a 27-year-old man who had undergone a successful treatment for pulmonary tuberculosis presenting with scrofuloderma with lesions of lupus on the overlying skin. [smjonline.org]

Treatment of skin tuberculosis shows similarities with other organ tuberculosis in many aspects. [ncbi.nlm.nih.gov]

Deep fungal infection[4] Management[edit] A dermatologist or general physician usually administers combination therapy of drugs used for tuberculosis, such as Rifampicin, Isoniazid and Pyrazinamide (possibly with either streptomycin or ethambutol).[3] Prognosis [en.wikipedia.org]

New search Scientific articles from MEDLINE for "Lupus Vulgaris" - English - French - German - Spanish - Portuguese - Italian All recent articles Therapy: by recall / by precision Diagnosis: by recall / by precision Etiology: by recall / by precision Prognosis [hon.ch]

The etiology and pathology of many diseases have been cleared up and the way leading to the elucidation of many mooted questions pointed out. [jamanetwork.com]

Consult HON's world-wide database of medical meetings Browse - New search Refine the search for "Lupus Vulgaris" Subheadings: complications / diagnosis / embryology / epidemiology / etiology / metabolism / microbiology / surgery / therapy Broader term [hon.ch]

Etiology Etiology is still elusive but it is thought to be multifactorial, involving a genetic predisposition. [orpha.net]

The etiology of RDD remains unknown. It is believed that RDD represents an exaggerated immune response to an infectious agent due to the polyclonal nature of infiltrating cells and the clinical course of the disease. [scielo.br]

BACKGROUND: The epidemiological aspects and diagnostic problems encountered in a rural set up are largely unknown. [ncbi.nlm.nih.gov]

Leprosy and tuberculosis: The epidemiological consequences of cross-immunity. Am J Public Health 1997;87:1923-7. [Google Scholar] [ijdvl.com]

Consult HON's world-wide database of medical meetings Browse - New search Refine the search for "Lupus Vulgaris" Subheadings: complications / diagnosis / embryology / epidemiology / etiology / metabolism / microbiology / surgery / therapy Broader term [hon.ch]

Leprosy and tuberculosis: The epidemiological consequences of cross-immunity. [dx.doi.org]

The term "lupus" may derive from the rapacity and virulence of the disease; a 1590 work described it as "a malignant ulcer quickly consuming the neather parts; ... very hungry like unto a woolfe".[3] Pathophysiology Lupus vulgaris often develops due to [wikidoc.org]

[…] develops due to inadequately treated pre-existing tuberculosis.[3] It may also develop at site of BCG vaccination.[4] Rarely, it has been shown to be associated with tattoo mark and also with long term bindi use, the so-called "bindi tuberculosis".[5][6] Pathophysiology [wikizero.com]

Pathophysiology The clinical manifestations of cutaneous tuberculosis primarily depend on the mode of infection, previous sensitization, and the immune status of the host. The mode of infection may be exogenous, autoinoculation, or endogenous. [clinicaladvisor.com]

Pathophysiology Infection with M tuberculosis results most commonly through exposure of the lungs or mucous membranes to infected aerosols. [emedicine.com]

Early diagnosis and treatment of lupus vulgaris might have prevented the development of carcinoma in lupo and ensuing metastatic death of the patient. [ncbi.nlm.nih.gov]

Treatment of specific manifestations of SLE is aimed at prevention of complications. [medical-dictionary.thefreedictionary.com]

1. Rai VM, Shenoi SD, Gowrinath K. Tuberculous gluteal abscess coexisting with scrofuloderma and tubercular lymphadenitis. Dermatol Online J. 2005;11(3):14.
2. Marcoval J, Servitje O, Moreno A, et al. Lupus vulgaris. Clinical, histopathologic, and bacteriologic study of 10 cases. J Am Acad Dermatol. 1992;26(3 Pt 2):404–407.
3. Barbagallo J, Tager P, Ingleton R, Hirsch RJ, Weinberg JM. Cutaneous tuberculosis: diagnosis and treatment. Am J Clin Dermatol 2002;3(5):319-328.
4. Farina MC, Gegundez MI, Pique E, et al. Cutaneous tuberculosis: a clinical, histopathologic, and bacteriologic study. J Am Acad Dermatol. 1995;33:433–440.
5. Tan SH, Tan BH, Goh CL, et al. Detection of Mycobacterium tuberculosis DNA using polymerase chain reaction in cutaneous tuberculosis and tuberculids. Int J Dermatol. 1999;38:122–127.
6. Andrew PW, Edward WJ. Cutaneous tuberculosis of the nose with unusual clinical and histological features leading to a delay in the diagnosis. Clin exp Dermatol. 1977;2:235-242.
7. Khandpur S, Reddy BS. Lupus vulgaris: Unusual presentations over the face. J Eur Acad Dermatol Venereol. 2003;17:706-710.
8. Sehgal V. Cutaneous tuberculosis. Dermatol Clin. 1994;12:645–53.
9. Aliağaoğlu C, Atasoy M, Güleç AI. Lupus vulgaris: 30 years of experience from eastern Turkey. Clin Exp Dermatol. 2009;34:e289.
10. İnönü H, Sezer E, Doruk S, Koseoglu D. Cutaneous tuberculosis: report of three lupus vulgaris cases: original image. Turkiye Klinikleri J Med Sci. 2009;29:788–91.