Lichenoid skin tubercle A18.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 18.02.2022

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Synonym(s)

lichen scrophulosorum; Tuberculosis cutis lichenoides; Tuberkulid lichenoides

History
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Hebra 1860

Definition
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Rare disease with appearance of follicular, lichenoid papules in hyperergic immune state. Expired organ tuberculosis is occasionally reported. Failure of the tuberculin response is uncharacteristic.

Etiopathogenesis
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Tuberculid. Unclear pathogenesis. The association between expired organ tuberculosis and a lichenoid tuberculid has not been clearly demonstrated.

Manifestation
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Occurs mainly in children and young people.

Localization
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Above all lateral torso-parts are attacked.

Clinical features
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Symmetrically arranged, grouped, follicular or perifollicular, acute conical, yellow-brown, reddish or skin-colored, lichenoid papules, sometimes solitary, sometimes confluent.

Histology
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Perifollicular or follicular tuberculoid structures: Langhans giant cells, small foci of necrosis. No mycobacteria detectable or growable.

Diagnosis
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Positive tuberculin reaction.

Differential diagnosis
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External therapy
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If necessary, lotio alba or glucocorticoid-externa like 0.25% prednicarbate cream(e.g. Dermatop cream) Usually regression after a few weeks. Recurrences possible.

Internal therapy
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Treatment of the underlying disease with systemic chemotherapy, see under tuberculosis cutis luposa.

Progression/forecast
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The disease develops slowly. Usually regression after a few weeks/months. Recurrences are possible.

Literature
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  1. Orfanos C (1970) Tuberculosis of the skin.In: HA Gottron et al. (Eds.) Dermatology and Venereology. Georg Thieme Verlag, Stuttgart, pp.316-318.
  2. Von Hebra F, Kaposi M (1860) Lichen scrofulosorum. In: Textbook of skin diseases. Volume 1, Enke, Erlangen, p. 198.
  3. von Hebra F (1868) Lichen scrofulosorum. In: Fagge CH, Pyesmoth PH (eds.) Diseases of the skin. Vol. 2, New Sydenham Society London, p. 58.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 18.02.2022