Rapidly metastatic carcinoma in lupo in a patient with lupus vulgaris for more than 50 years.
According to current statistics of the WHO, tuberculosis is the infectious disease that causes the most deaths worldwide. Its most common cutaneous manifestation is lupus vulgaris which is seldom diagnosed today. A 69-year old immunocompetent woman complained of a partly elevated, partly sclerotic plaque on her left thigh which had been present for more than 55 years before slowly becoming ulcerated. After biopsy and subsequent excision of the 13 cm ulcer, the diagnosis of carcinoma in lupo with lymph node metastasis was made. Cutaneous and additional nodal metastases appeared rapidly. Tuberculostatic therapy was initiated. Despite systemic chemotherapy the tumor subsequently progressed and the patient died of metastatic carcinoma in lupo 15 months after the initial diagnosis. Early diagnosis and treatment of lupus vulgaris might have prevented the development of carcinoma in lupo and ensuing metastatic death of the patient.
Wulff-Woesten
Andrea
A
Department of Dermatology and Allergology, Dorothea Christiane Erxleben Clinic, Quedlinburg, Germany.
Hildebrandt
Uwe
U
Leverkus
Martin
M
Ulrich
Jens
J
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008177:Lupus Vulgaris / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary*; D017211:Treatment Failure
D000970:Antineoplastic Agents