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Giornale Italiano di Dermatologia e Venereologia 2001 June;136(3):209-11

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Lupus vulgaris. Case report

Gisondi P., Guadagni M., Alinovi A.

Università degli Studi - Parma Facoltà di Medicina e Chirurgia Istituto di Dermatologia Medica e Chirurgica


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Lupus vulgaris is a reinfection tuberculosis of the skin occurring in previously sensitised individuals.
Lesions over normal skin may be the result of either direct extension or lymphatic spread or hematogenous spread. Lupus vulgaris may appear in the scar of scrofuloderma or after BCG vaccination. In some instances Lupus vulgaris appears over a primary inoculation site. Lupus vulgaris usually occurs as a soft, brownish-red, serpiginous plaque localised on the face. Apple-jelly-nodules may be visible on diascopy. As well as the classical plaque, the hypertrophic, ulcerative, vegetative, papular and nodular variants are well recognised. The histopathologic picture of Lupus vulgaris consists of tuberculoid granuloma with caseation necrosis. A case of Lupus vulgaris occurring on the scar of scrofuloderma of a 60 years old female patient is described. The clinical, histological, diagnostic and therapeutic features of Lupus vulgaris are discussed. The direct detection of a mycobacterial DNA using PCR provides a rapid, reliable and sensitive technique for the diagnosis of Lupus vulgaris.

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