Lupus vulgaris

Last Updated: 2023-07-07

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

ICD11: 1B12.8

  • Lupus erythematosus

Robert Willan (1757-1812).

  • Tuberculosis cutis luposa.

The most common form of cutaneous tuberculosis.

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

Cutaneous TB infection occurs by haematogenous, lymphogenous seeding or per continuitatem, but can also occur exogenously.

  • Localisation
  • Face, mammae, extremities and mucous membranes.
  • Primary florescence: erythematous-brownish, lenticular, partly serpiginous, partly confluent papules. Diascopically, an apple jelly-coloured nodule is seen. It spreads to the periphery. If one breaks through the skin with the light! If the mild papule breaks through the skin, it is called a positive probe phenomenon or stylet phenomenon.
  • Frequently, there is also pulmonary tuberculosis.

  • Clinic.
  • Tuberculin test (Mendel-Mantoux).
  • Quantiferon test.
  • Biopsy (both dermatopathological and microbiological examination).
  • Thoracic X-ray or CT- chest.
  • Sonography of abdomen and kidneys.
  • Collect sputum on 3 consecutive mornings (fasting up to 4h).
  • Pass urine on 3 consecutive mornings (fluid restriction the night before!).
  • Bronchoalveolar lavage (BAL).

Partially carcinomatous degeneration possible (carcinoma in lupo).

Chronic progression.

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