Lichen scrofulosorum: importance of early recognition

Molpariya, Anupama; Ramesh, V.

doi:10.1111/ced.13050

Cited by 10 publications

(5 citation statements)

References 17 publications

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“…Darier first introduced the concept of tuberculide in 1896. [ 8 ] True tuberculides are classified as PNT, erythema induratum of Bazin, and LS (6). EN, a type of septal panniculitis, is an immunological reaction, that is, delayed-type hypersensitivity reaction to various stimuli (e.g., infections, drugs, malignant diseases, and auto-immune diseases).…”

Section: Discussionmentioning

confidence: 99%

Clinico-Laboratory Profile of Tuberculides: An Experience at a Tertiary Care Centre from Chandigarh, India

Poonia,

Thami,

Dogar

et al. 2024

Indian Journal of Dermatology

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Background: Tuberculides are characterised by delayed-type of immunologic reactions to Mycobacterium tuberculosis or its products in immuno-competent individuals. We herein describe clinico-epidemiological features and response to treatment in patients with tuberculides from a tertiary care centre from North India. Methods: This was a retrospective analysis of the clinical records of all the cutaneous tuberculosis (TB) patients (year 2000–2019) enrolled in the TB clinic. The patient records fulfilling the diagnostic criteria of tuberculides were considered for analysis. Results: A total of 225 patients attended the tuberculosis clinic; out of this, 34 were diagnosed as tuberculides. Out of these 34 cases, 21 were identified as LS, 2 erythema induratum of Bazin, 1 papulonecrotic tuberculide, and 10 erythema nodosum. History of contact to open cases of TB was present in 15/34 (44.1%) patients. History of BCG vaccination was found in 15/34 (44.1%) patients. The focus of underlying TB could be identified in 20/34 (58.8%) patients. Skin biopsy was performed in all patients. In all patients, the diagnosis was confirmed by clinico-pathological correlation, positive TST, and the underlying focus of TB. All patients received 6 months regimen of anti-tubercular therapy with first-line drugs. Conclusion: In this study, we demonstrated various forms of tuberculides; lichen scrofulosorum was the most common form. We also included erythema nodosum cases also, which responded well to ATT. Observation from our study showed that tuberculides are important cutaneous markers for underlying tuberculosis infection, which helps in early detection of occult tuberculosis and timely management.

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Section: Discussionmentioning

confidence: 99%

Clinico-Laboratory Profile of Tuberculides: An Experience at a Tertiary Care Centre from Chandigarh, India

Poonia,

Thami,

Dogar

et al. 2024

Indian Journal of Dermatology

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“…Table 2 depicts the incidence of LS observed in various major studies till date 1,2,6–12 . The underreporting of LS could be due to its waxing and waning course and its clinical similarity to various other dermatoses 13 . The differential diagnosis of LS includes lichen spinulosus, lichen nitidus, keratosis pilaris, pityriasis rubra pilaris, and lichenoid sarcoidosis 14,15 .…”

Section: Discussionmentioning

confidence: 99%

Clinico‐epidemiological profile of lichen scrofulosorum: a 22‐year, single‐center, retrospective study

et al. 2021

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Background Lichen scrofulosorum (LS) represents immunologic reaction to the Mycobacterium tuberculosis antigen and presents with subtle, asymptomatic, grouped follicular papules over the trunk and shows good therapeutic response to antitubercular drugs. Objective To study the clinical and epidemiological characteristics of patients diagnosed with LS. Materials and Methods A single‐center retrospective review of patients diagnosed with LS from 1997 to 2018 was conducted. The data pertained to clinico‐epidemiological profile, BCG vaccination, Mantoux positivity, laboratory investigations, coexistent focus of tuberculosis, and response to antitubercular treatment (ATT). Results LS cases constituted 15.2% (221/1458) of all the patients diagnosed with cutaneous tuberculosis (CTB). Of these, 156 (70.5%) were pediatric patients. All patients presented with multiple follicular and perifollicular grouped papules. The trunk was the most common site involved (98.6%), followed by lower limb (25.33%), upper limb (15.83%), face (5%), and external genitalia (3.6%). Evidence of BCG vaccination and Mantoux test positivity was observed in 52.03 and 83.2%, respectively. Coexistent TB focus was detected in 134 (60.6%) patients in lymph nodes, lungs, abdomen, and unusual sites such as intracranial, endometrium, and eye. Twenty‐eight patients (12.66%) had coexistent other clinical forms of CTB. Clinical diagnosis of LS was confirmed on histology that revealed chiefly periappendageal epithelioid cell granuloma. Response to ATT was good with complete resolution of lesion in 8–12 weeks. Conclusion LS appears to be an underdiagnosed entity. Subtle and asymptomatic lesions of LS are often missed, thereby necessitating a high index of suspicion and appropriate evaluation of the underlying TB focus.

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“…Lichen scrofulosorum is a tuberculid usually seen in children and the adolescent age group. [ 1 2 ] We report the dermoscopic features of two children with clinically and histopathologically diagnosed lichen scrofulosorum.…”

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confidence: 99%