|Other names: Tuberculosis luposa|
Lupus vulgaris (also known as tuberculosis luposa) are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around the nose, eyelids, lips, cheeks, ears and neck. It is the most common Mycobacterium tuberculosis skin infection. The lesions may ultimately develop into disfiguring skin ulcers if left untreated.
Signs and symptoms
Lupus vulgaris often develops due to inadequately treated pre-existing tuberculosis. It may also develop at site of BCG vaccination. Rarely, it has been shown to be associated with tattoo mark and also with long term bindi use, the so-called "bindi tuberculosis".
The condition should be distinguished from:
- Basal cell carcinoma
- Discoid lupus erythomatosus
- Deep fungal infection
A dermatologist or general physician usually administers combination therapy of drugs used for tuberculosis, such as Rifampicin, Isoniazid and Pyrazinamide (possibly with either streptomycin or ethambutol).
In longstanding scarred lesions, squamous cell carcinoma can develop.
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 by Niels Ryberg Finsen using a form of "concentrated light radiation" now known as Photobiomodulation which won him a Nobel Prize. Queen Alexandra of Great Britain, (1844–1925), consort to Edward the VII, as the inscription on the bronze statue of her at the London Hospital, notes, "Introduced to England the Finsen light cure for Lupus, and presented the first lamp to this hospital".
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 as lupus 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".
- Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. Chapter 74. ISBN 978-1-4160-2999-1.
- James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. p. 335. ISBN 978-0-7216-2921-6.
- Dermatology: An Illustrated Colour Text, 3rd ed. Elsevier Health Sciences. 2002. p. 46. ISBN 9780443071409.
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- Ghorpade, A (27 August 2003). "Lupus vulgaris over a tattoo mark--inoculation tuberculosis". Journal of the European Academy of Dermatology and Venereology. 17 (5): 569–71. doi:10.1046/j.1468-3083.2003.00787.x. PMID 12941097. S2CID 45399120.
- Mishra, Gyanshankar; Rathi, Sushil; Mulani, Jasmin (2015). "Bindi Tuberculosis – Lupus Vulgaris Associated with Bindi Use: A Case Report". Journal of Clinical and Diagnostic Research. 9 (5): OD04–OD05. doi:10.7860/JCDR/2015/12164.5899. PMC 4484101. PMID 26155509.
- Varadraj, Vasant Pai (2014). "A clinico-histopathological study of lupus vulgaris: A 3 year experience at a tertiary care centre". Indian Dermatol Online J. 5 (4): 461–465. doi:10.4103/2229-5178.142497. Archived from the original on 2021-08-28. Retrieved 2021-05-16 – via PMC.
- "Lupus", Oxford English Dictionary, online second edition. Accessed 2006
- Image at University of Iowa (graphic)
- Image of lupus vulgaris, 1914 Archived 2015-02-18 at the Wayback Machine from Our Friend, the Sun: Images of Light Therapeutics from the Osler Library Collection, c. 1901-1944 Archived 2021-05-02 at the Wayback Machine. Digital exhibition by the Osler Library of the History of Medicine, McGill University.