Cutaneous Tuberculosis: Issues in the Diagnose

Abstract

Liquenscrofulosorum, also known as tuberculosis cutis lichenoides, is a rare tuberculid that presents as lichenoid eruptions of minute papule, is an uncommon disease and easily misdiagnosed. The lesions are usually asymptomatic, closely grouped, skin colored to reddish-brown papules, often perifollicular. The eruption usually is associated with strongly positive tuberculin reaction. Diagnosis of the lesions can be difficult, as they resemble many other dermatological conditions that are often primarily considered. We report a case of lichen scrofulosorum in an adult male with a florid medical history. He responded promptly to antitubercular therapy with a complete clearance of the lesions after one month.

Background

This case highlights the uncommon, easily mis diagnosed but readily treatable case of lichen scrofulosorum.

Introduction

Liquen scrofulosorum., also known as tuberculosis cutis lichenoides, is a rare tuberculid that presents as lichenoid eruptions of minute papule, is an uncommon disease and easily misdiagnosed. The lesions are usually asymptomatic, closely grouped, skin colored to reddish-brown papules, often perifollicular.

Case Presentation

A 50 -year-old male presented with a history of itching skin rash for 1 month, accompanied by cough and shortness of breath more intense at night, he reports that the lesions started in the face and now is spread all over the body.

An examination revealed Vital signs: BP: 83/59 mmHg, Pulse: 128, Spo2: 93%

HB:7,8 g/dl HGT: 8,9 mmol/L

Skin: Generalized erythematous popular rash over the body from the face till the feet, with some lesions in plaques on the chest, not blister or vesicles.

Mouth: Whitish lesions in the oral mucous extended to the soft paladar.

Chest: A Skin biopsy was planned in consensus with the dermatologist (Figure 1-3).