title: Paradoxical reaction to antituberculosis therapy in a patient with lupus vulgaris.
abstract: Patients receiving treatment for tuberculosis may experience an unexpected deterioration of their disease; this is known as a paradoxical reaction. We present the case of a 59-year-old man with lupus vulgaris who experienced a paradoxical deterioration of cutaneous lesions after starting antituberculosis therapy. The reaction was self-limiting; the lesions gradually improved, and the final outcome was very good. Paradoxical reactions are well-known in patients with human immunodeficiency virus (HIV) infection who start antiretroviral therapy, but they can also occur in non-HIV-infected patients with tuberculosis who start antituberculosis therapy. In the literature reviewed, paradoxical reactions involving skin lesions were described in patients with miliary tuberculosis. The case we report is the first of a paradoxical reaction in lupus vulgaris. The increasing frequency of tuberculosis in Spain could lead to a rise in the number of paradoxical reactions.
authors.affiliation: Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España. Electronic address: raquel.santesteban@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Santesteban
authors.affiliation: Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: B
authors.initials: B
authors.lastname: Bonaut
authors.affiliation: Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: A
authors.initials: A
authors.lastname: Córdoba
authors.affiliation: Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España.
authors.forename: I
authors.initials: I
authors.lastname: Yanguas
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D006801:Humans; D008177:Lupus Vulgaris / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000995:Antitubercular Agents
keywords: Cutaneous tuberculosis; Immune reconstitution syndrome; Lupus vulgar; Lupus vulgaris; Mycobacterium tuberculosis; Síndrome de reconstitución inmune; Tuberculosis cutánea