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Ulcerative lupus vulgaris over nose, leading to cosmetic deformity.

Nair PA, Mehta MJ, Patel BB - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis.In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare.A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and V.D., Pramukhswami Medical College, Karamsad, Gujarat, India.

ABSTRACT
Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis. In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare. Ulcerative variant particularly over nose causes destruction of cartilage, leading to irreversible deformities and contracture. High-index of suspicion is required for early diagnosis and prevention of cosmetic deformity. A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

No MeSH data available.


Related in: MedlinePlus

(a) Ulcerative erythematous, scaly plaque, involving nasal bridge, both naso labial fold, with pus and sero-sanguineous discharge. (b) After 6 months of therapy, healed lesion with an atrophic scar
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Figure 1: (a) Ulcerative erythematous, scaly plaque, involving nasal bridge, both naso labial fold, with pus and sero-sanguineous discharge. (b) After 6 months of therapy, healed lesion with an atrophic scar

Mentions: A 20-year-old male presented to skin out patient department of tertiary care center with history of (h/o) elevated lesion and ulceration over nose and adjoining parts of cheeks since 1½ year with no nasal symptoms. It started with a single papule over left cheek which gradually enlarged and progressed in due time to involve nasal bridge, extending to right side of nose. He developed swelling over right side of neck 3 months back. Patient was treated with oral and topical antibiotics by general physicians showing no improvement. Patient had h/o weight loss and decreased appetite but no h/o cough and fever. No h/o trauma at that site. No past h/o of pulmonary TB present. Patient's mother died of pulmonary TB 2 years back. General and systemic examinations were normal. Cutaneous examination showed well-defined erythematous, scaly plaque of around 8 cm × 4 cm in size, involving nasal bridge, both naso-labial folds and cheeks. Two erythematous papules were present over left cheek separately. Single ulcer of 3 cm × 3 cm in size at the center of nose, with pus and sero-sanguineous discharge was seen [Figure 1a]. Right sided submandibular and jugular nodes were enlarged and tender. Nasal septum, lips and oral mucosa were normal. Anterior rhinoscopy and nasal endoscopy findings were normal.


Ulcerative lupus vulgaris over nose, leading to cosmetic deformity.

Nair PA, Mehta MJ, Patel BB - Indian J Dermatol (2015 Jan-Feb)

(a) Ulcerative erythematous, scaly plaque, involving nasal bridge, both naso labial fold, with pus and sero-sanguineous discharge. (b) After 6 months of therapy, healed lesion with an atrophic scar
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318033&req=5

Figure 1: (a) Ulcerative erythematous, scaly plaque, involving nasal bridge, both naso labial fold, with pus and sero-sanguineous discharge. (b) After 6 months of therapy, healed lesion with an atrophic scar
Mentions: A 20-year-old male presented to skin out patient department of tertiary care center with history of (h/o) elevated lesion and ulceration over nose and adjoining parts of cheeks since 1½ year with no nasal symptoms. It started with a single papule over left cheek which gradually enlarged and progressed in due time to involve nasal bridge, extending to right side of nose. He developed swelling over right side of neck 3 months back. Patient was treated with oral and topical antibiotics by general physicians showing no improvement. Patient had h/o weight loss and decreased appetite but no h/o cough and fever. No h/o trauma at that site. No past h/o of pulmonary TB present. Patient's mother died of pulmonary TB 2 years back. General and systemic examinations were normal. Cutaneous examination showed well-defined erythematous, scaly plaque of around 8 cm × 4 cm in size, involving nasal bridge, both naso-labial folds and cheeks. Two erythematous papules were present over left cheek separately. Single ulcer of 3 cm × 3 cm in size at the center of nose, with pus and sero-sanguineous discharge was seen [Figure 1a]. Right sided submandibular and jugular nodes were enlarged and tender. Nasal septum, lips and oral mucosa were normal. Anterior rhinoscopy and nasal endoscopy findings were normal.

Bottom Line: Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis.In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare.A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and V.D., Pramukhswami Medical College, Karamsad, Gujarat, India.

ABSTRACT
Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis. In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare. Ulcerative variant particularly over nose causes destruction of cartilage, leading to irreversible deformities and contracture. High-index of suspicion is required for early diagnosis and prevention of cosmetic deformity. A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

No MeSH data available.


Related in: MedlinePlus