[Tuberculous lupus].
Cutaneous tuberculosis accounts for 2% of all extrapulmonary tuberculosis and is one of the multiple clinical presentations of extrapulmonary tuberculosis. We report a case of cutaneous tuberculosis with unusual clinical and histological presentations.


METHODS
We report the case of a 29-year-old woman with plurifocal tuberculous lupus. Histological examination of cutaneous lesions revealed the presence of a granuloma with caseum necrosis. Chest X-ray showed a severe pulmonary tuberculosis lesion. The Mantoux test performed by intradermal injection was positive. Skin lesion PCR and sputum culture were negative. Both skin and pulmonary lesions responded to antituberculous treatment.


CONCLUSIONS
Lupus vulgaris is commonly presents on the head and neck. The diagnosis may be difficult when lupus vulgaris occurs at unexpected sites or in unusual clinical presentations. Caseum necrosis observed in our patient was unusual.
El Fekih
N
N
Service de dermatologie, hôpital Charles-Nicolle, boulevard du 9-Avril, Bab-Saadoun, 1006 Tunis, Tunisie. fekih.nadia@planet.tn
Fazaa
B
B
Kerkeni
N
N
Sfia
M
M
Zeglaoui
F
F
Zermani
R
R
Bouacha
H
H
Kamoun
M R
MR
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006099:Granuloma / Q000382:microbiology / Q000473:pathology; D006801:Humans; D009336:Necrosis; D012867:Skin / Q000473:pathology; D012882:Skin Tests; D014382:Tuberculosis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
D000995:Antitubercular Agents