| Lupus vulgaris | |
|---|---|
| Other names | Tuberculosis luposa |
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| Lupus vulgaris | |
| Specialty | Infectious disease |
Lupus vulgaris (also known astuberculosis luposa[1]) are painful cutaneoustuberculosis skin lesions withnodular appearance, most often on the face around the nose,eyelids, lips, cheeks, ears[2] and neck. It is the most commonMycobacterium tuberculosis skin infection.[3] The lesions may ultimately develop into disfiguringskin ulcers if left untreated.
It begins as painless reddish-brown nodules which slowly enlarge to form irregularly shaped redplaque.[3]
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Lupus vulgaris often develops due to inadequately treated pre-existingtuberculosis.[3] It may also develop at site ofBCG vaccination.[4] Rarely, it has been shown to be associated with tattoo marks.[5]
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Histologically, it shows presence of epithelioid cellgranulomas withLanghans giant cells with or without centralcaseation necrosis in thedermis.[6]
Ondiascopy, it shows characteristic "apple-jelly" color. Biopsy will reveal tuberculoidgranuloma with few bacilli.Mantoux test is positive.
The condition should be distinguished from:
A dermatologist or general physician usually administers combination therapy of drugs used for tuberculosis, such asrifampicin,isoniazid, andpyrazinamide (possibly with eitherstreptomycin orethambutol).[3]Adequate vitamin D, from sufficient sunlight or supplements, prevents and cures Lupus vulgaris. (Holick MF, 2010. The vitamin D solution, P10.)[unreliable source?][medical citation needed]
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In longstanding scarred lesions,squamous-cell carcinoma can develop.[3]
In the 19th century, the chronic and progressive nature of this disease was particularly marked: it remained active for ten years, twenty years, or even longer and, proved resistant to all treatment until the breakthrough byNiels Ryberg Finsen using a form of "concentrated light radiation" orlight therapy (now known asphotobiomodulation) which won him a Nobel Prize.[citation needed]
The inscription on a bronze statue ofQueen Alexandra of Great Britain, (1844–1925), consort toEdward VII, at theRoyal London Hospital, notes that she "introduced to England the Finsen light cure for Lupus, and presented the first lamp to this hospital".[citation needed]
The term "lupus" (meaning "wolf" in Latin) to describe an ulcerative skin disease dates to the late thirteenth century, though it was not until the mid-nineteenth that two specific skin diseases were classified aslupus erythematosus and lupus vulgaris. The term may derive from the rapacity and virulence of the disease; a 1590 work described it as "a malignant ulcer quickly consuming the neather parts; ... very hungry like unto a woolfe".[7]
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