Scrofuloderma associated with lupus vulgaris and tuberculosis verrucosa cutis in an immunocompetent boy

Abstract

Cutaneous tuberculosis is protean and diverse in its clinical manifestations, it usually manifests as a single clinical morphological form. However, three different morphological forms of cutaneous tuberculosis such as scrofuloderma (SFD), lupus vulgaris (LV), and tuberculosis verrucosa cutis (TVC) may coexist in the same patient. Herein, we present coexistence of SFD, LV, and TVC in a 14-year-old boy, initially developed SFD in the left axilla and subsequently developed LV of the left elbow followed by TVC involving pubic region. Typical clinical morphology and epithelioid cell granuloma with Langhans giant cells on histopathological examination of the biopsy taken from the plaque of elbow and pubic region corroborated in establishing the diagnosis of SFD, LV, and TVC. The considerable clinical improvement was observed after 12 weeks of instituting four drugs antitubercular treatment.

Keywords

• Langhans giant cell
• Lowenstein–Jensen's medium
• lupus vulgaris
• scrofuloderma
• tuberculosis verrucosa cutis