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SHORT COMMUNICATION
Year : 1998  |  Volume : 64  |  Issue : 4  |  Page : 183-184

Varied forms of lupus vulgaris




Correspondence Address:
K Anandam


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Source of Support: None, Conflict of Interest: None


PMID: 20921758

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  Abstract 

Two unusual forms of lupus vulgaris affecting the perinasal skin are reported. One presented with mutilating type of lupus vulgaris while the other had vegetative type


Keywords: Lupus vulgaris, Tuberculosis


How to cite this article:
Anandam K, Seethamma K, Venkateswarlu K, Adithya S. Varied forms of lupus vulgaris. Indian J Dermatol Venereol Leprol 1998;64:183-4

How to cite this URL:
Anandam K, Seethamma K, Venkateswarlu K, Adithya S. Varied forms of lupus vulgaris. Indian J Dermatol Venereol Leprol [serial online] 1998 [cited 2019 Nov 12];64:183-4. Available from: http://www.ijdvl.com/text.asp?1998/64/4/183/4687



  Introduction Top


Lupus vulgaris of skin can be a primary or secondary manifestation of tuberculosis. Though the common type is plaque type, rarely mutilating and vegetative forms also are found. The present report is of such manifestations in 2 patients.


  Case Reports Top



  Case No:1 Top


A 15-year-old male patient presented with scaly and vegetating type of lesions around the mouth and ala nasi, The condition started around the tip of the nose at the age of one year [Figure - 1]. Simultaneously there was discharge per nose. The condition gradually spread to involve the lower part of nose and perioral regions. On examination there were vegetating type of lesions around the mouth, and also on the lower part of the nose. There was perforation of cartilaginous portion of nasal septum. All other systems were normal. Routine investigations on blood were normal except a raised ESR (60mm first h). Blood VDRL was non-reactive. X-ray chest, and barium meal x-rays of the intestine were normal. Mantoux test was strongly positive. Histopathological examination of the bit from the lesion showed the typical changes of tuberculosis.


  Case No:2 Top


A-46-year-old male patient presented with the complaints of ulceration of the upper lip and deformity of the nose and loss of all teeth [Figure - 2]. The condition first started as bleeding per nose 2 years ago and later spread to involve the nose and the area between nose and upper lip. On examination there was ulceration of nose and skin below the nose. All teeth were lost. Nasal septum was deformed but not perforated. On investigations it was found that ESR was 70 mm/1st hour and VDRL was non-reactive. Biopsy confirmed the diagnosis of tuberculosis. There was no evidence of tuberculosis any where else.


  Discussion Top


Usually tuberculosis around the mouth and nose is associated with tuberculosis of lungs or gastrointestinal system. Here in these two cases there was no evidence of that. Consequently it must be considered that the patients suffered from lupus vulgaris of skin only. The first case was that of vegetating type while the second one was mutilating or destructive type as there was scaling and crusting and hypertrophy in the first case, and atrophy with ulceration in the second. However, the margin between the two types may be blurred and vegetating can go into mutilating type, over a course of time.

Though it is generally thought that lupus vulgaris can be either primary or re-infectious types[1] in India it is generally re-infectious type only.



 
  References Top

1.Ramesh V, Misra RS, Jain RK. Secondarytuberculosis of skin: clinical features and problems is diagnosis, Int J Dermatol, 1987;26:578-581.  Back to cited text no. 1    


    Figures

[Figure - 1], [Figure - 2]



 

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