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Image Number 335 (Lupus vulgaris)

 
Morphology:
Plaque

Diagnosis: Lupus vulgaris

Site: Face

Sex: M

Age: 56

Type: Clinical

Description: A large erythematous indurated plaque covering the right mandibular region

Submitted by: Irfan Bari

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Differential Diagnosis

History:

Among infectious diseases, Tuberculosis (TB) is the leading cause of death. Although pulmonary TB has been very prevalent on this planet, the incidence of cutaneous TB appears low. In areas such as India or China where TB prevalence is quite high, cutaneous manifestations of TB are found in less than 0.1% of individuals seen in dermatology clinics.  Lupus vulgaris is considered the most common form. It is a chronic and progressive form of cutaneous TB with most variable presentation. Lesions often persist for years before diagnosis and can be disfiguring. One such case is reported here who presented with persistent plaque over right side of his face. He was misdiagnosed and mismanaged for many years until skin biopsy revealed the diagnosis of cutaneous tuberculosis. He was treated accordingly and showed highly satisfactory response to anti tuberculous regimen.



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