Lupus vulgaris. Clinical, histopathologic, and bacteriologic study of 10 cases.
BACKGROUND: Lupus vulgaris (LV) represents the most common form of cutaneous tuberculosis in Europe. However, recent reports from European countries are few and usually limited to isolated cases. OBJECTIVE: We report the clinical, histopathologic, and bacteriologic data in 10 patients with LV. METHODS: The diagnosis of LV was made according to a combination of clinical, histologic, and bacteriologic criteria. In each case a biopsy specimen was obtained for histopathologic study and mycobacteriologic culture. All but one patient received a 9-month course of combined antituberculous therapy. RESULTS: Five patients had evidence of either previous or simultaneous tuberculous foci other than LV. Mycobacterium tuberculosis was isolated from cutaneous lesions in five cases. The histologic study revealed a variable granulomatous reaction, including tuberculoid granulomas, sarcoidlike granulomas, and a "mixed" granulomatous reaction. CONCLUSION: Although different mechanisms could be implicated in the development of LV, an association with visceral tuberculosis is not infrequent. Combined antituberculous therapy should be the treatment of choice in these patients.