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Images/Instrument in Dermatology/Dermatosurgery
2024
:4;
36
doi:
10.25259/CSDM_11_2024

Clinicodermoscopic features of lichen scrofulosorum – A rare form of cutaneous tuberculosis

Department of Dermatology, and Venereology, S.C.B. Medical College and Hospital, Cuttack, Odisha, India
Department of Pathology, S.C.B. Medical College and Hospital, Cuttack, Odisha, India
Corresponding author: Siddhartha Dash, Department of Dermatology, and Venereology, S.C.B. Medical College and Hospital, Cuttack, Odisha, India. siddharth101990@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Dash S, Bhoi A, Mohanty S. Clinicodermoscopic features of lichen scrofulosorum – A rare form of cutaneous tuberculosis. CosmoDerma. 2024;4:36. doi: 10.25259/CSDM_11_2024

A 35-year-old male presented with multiple asymptomatic, skin-colored to erythematous, grouped, and discrete follicular papules of size ranging from 3 to 5 mm, mostly over the trunk for 15 days [Figure 1a]. There was no history of cough, fever, night sweats, weight loss or any other systemic complaints. He denied any past or family history of tuberculosis. Bacillus Calmette-Guerin scar was present on his left arm. Systemic examination was unremarkable.

Figure 1:
(a) Multiple, skin-colored to erythematous, grouped, and discrete follicular papules. (b) Dermoscopy (DermLite, DL4, ×10 magnification) under polarized mode showing pale round monomorphic grouped perifollicular large dots with a central black follicular plug with perilesional erythema. (c) Histopathology showing perifollicular and perieccrine non-caseating tuberculoid granuloma (Hematoxylin and Eosin, ×400). (d) Complete resolution of the lesion after six months of antitubercular treatment.

Dermoscopy under polarized light (DermLite, DL4, ×10 magnification) revealed pale round monomorphic grouped perifollicular large dots with a central black follicular plug with perilesional erythema [Figure 1b]. Differential diagnoses of lichen scrofulosorum, papular mucinosis, papular sarcoidosis, and histoid leprosy were kept. Mantoux test showed 3 mm induration after 48 h. The biochemical, hematological, and radiological investigations were within normal limits. Histopathology revealed superficial non-caseating tuberculoid granuloma around hair follicles and sweat ducts [Figure 1c]. Based on clinical and histopathological findings, a final diagnosis of lichen scrofulosorum was kept, and the patient was started on antitubercular treatment (ATT) with complete resolution after six months [Figure 1d]. Our case presented with typical morphology, dermoscopic, and histopathologic picture. Although the Mantoux test was negative, there was a complete response to ATT.

Ethical approval

The Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.


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