Lupus vulgaris: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Changes made per Mahshid's request)
 
(8 intermediate revisions by 2 users not shown)
Line 2: Line 2:
{{SI}}
{{SI}}


{{CMG}}; {{AE}} {{AN}}
{{CMG}}; {{AE}} {{AN}} {{KS}}


{{SK}} Tuberculosis luposa
{{SK}} Tuberculosis luposa
Line 16: Line 16:


==Pathophysiology==
==Pathophysiology==
Lupus vulgaris often develops due to inadequately treated pre-existing [[tuberculosis]]. It may also develop at site of BCG vaccination. <ref name=ch>{{cite book|title=Dermatology - A colour handbook, 2nd ed|year=2010|publisher=Manson Publishing|isbn=9781840765960|pages=216}}</ref>
* Lupus vulgaris often develops due to inadequately treated pre-existing [[tuberculosis]]. It may also develop at site of BCG vaccination. <ref name=ch>{{cite book|title=Dermatology - A colour handbook, 2nd ed|year=2010|publisher=Manson Publishing|isbn=9781840765960|pages=216}}</ref>
* It begins as painless reddish-brown nodules which slowly enlarge to form irregularly shaped red.
==Diagnosis==
===Physical Examination===
====Skin====
=====Extremity=====
<gallery>
Image:Lupus vulgaris01.jpg|Lupus vulgaris. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
 
 
Image:Lupus vulgaris02.jpg|Lupus vulgaris. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
 
 
 
 
 
Image:Lupus vulgaris03.jpg|Lupus vulgaris. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
 


===Pathology===
It begins as painless reddish-brown nodules which slowly enlarge to form irregularly shaped red


===Histology===
 
Image:Lupus vulgaris04.jpg|Lupus vulgaris. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
 
 
 
 
Image:Lupus vulgaris05.jpg|Lupus vulgaris. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
 
</gallery>
 
 
 
 
===Microscopic Pathology===
[[Image:Lupus histology.jpg|left|300px]]
<br clear="left"/>
[[Histologically]], it shows well-formed granulomas with necrotic centers in [[dermis]].
[[Histologically]], it shows well-formed granulomas with necrotic centers in [[dermis]].


Line 32: Line 62:
* [[Mycosis|Deep fungal infection]]<ref name='ch' />
* [[Mycosis|Deep fungal infection]]<ref name='ch' />


==Prognosis==
==Complications==
In long standing scarred lesion, squamous cell carcinoma can develop.
In long standing scarred lesion, [[squamous cell carcinoma]] can develop.


==Diagnosis==
==Diagnosis==
===Physical Examination===
===Physical Examination===
[[Image:Lupus vulgaris.jpg|left|250px]]
[[Image:Lupus vulgaris.jpg|left|200px]]   
[[Image:Lupus vulgaris case.jpg|left|200px|Lupus vulgaris in a woman in the 19th century]]
[[Image:Lupus vulgaris case1.jpg|left|200px|Hyperkeratotic changes in the skin]]
<br clear="left"/>
<br clear="left"/>
===Laboratory Findings===
===Laboratory Findings===
On [[diascopy]], it shows characteristic "apple-jelly" color. Biopsy will reveal tuberculoid [[granuloma]] with few bacilli.
====Diascopy====
On [[diascopy]], it shows characteristic "apple-jelly" color.
====Biopsy====
Biopsy will reveal tuberculoid [[granuloma]] with few bacilli.


==Treatment==
==Treatment==
Line 61: Line 97:
[[Category:Tuberculosis]]
[[Category:Tuberculosis]]
[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Infectious disease]]
 
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs content]]


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 18:14, 18 September 2017

WikiDoc Resources for Lupus vulgaris

Articles

Most recent articles on Lupus vulgaris

Most cited articles on Lupus vulgaris

Review articles on Lupus vulgaris

Articles on Lupus vulgaris in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Lupus vulgaris

Images of Lupus vulgaris

Photos of Lupus vulgaris

Podcasts & MP3s on Lupus vulgaris

Videos on Lupus vulgaris

Evidence Based Medicine

Cochrane Collaboration on Lupus vulgaris

Bandolier on Lupus vulgaris

TRIP on Lupus vulgaris

Clinical Trials

Ongoing Trials on Lupus vulgaris at Clinical Trials.gov

Trial results on Lupus vulgaris

Clinical Trials on Lupus vulgaris at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Lupus vulgaris

NICE Guidance on Lupus vulgaris

NHS PRODIGY Guidance

FDA on Lupus vulgaris

CDC on Lupus vulgaris

Books

Books on Lupus vulgaris

News

Lupus vulgaris in the news

Be alerted to news on Lupus vulgaris

News trends on Lupus vulgaris

Commentary

Blogs on Lupus vulgaris

Definitions

Definitions of Lupus vulgaris

Patient Resources / Community

Patient resources on Lupus vulgaris

Discussion groups on Lupus vulgaris

Patient Handouts on Lupus vulgaris

Directions to Hospitals Treating Lupus vulgaris

Risk calculators and risk factors for Lupus vulgaris

Healthcare Provider Resources

Symptoms of Lupus vulgaris

Causes & Risk Factors for Lupus vulgaris

Diagnostic studies for Lupus vulgaris

Treatment of Lupus vulgaris

Continuing Medical Education (CME)

CME Programs on Lupus vulgaris

International

Lupus vulgaris en Espanol

Lupus vulgaris en Francais

Business

Lupus vulgaris in the Marketplace

Patents on Lupus vulgaris

Experimental / Informatics

List of terms related to Lupus vulgaris

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2] Kiran Singh, M.D. [3]

Synonyms and keywords: Tuberculosis luposa

Overview

Lupus vulgaris[1] are painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around nose, eyelids, lips, cheeks and ears.[2]:335 The lesions may ultimately develop into disfiguring skin ulcers if left untreated.

Historical Perspective

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" 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 "lupus" 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".[3]

Pathophysiology

  • Lupus vulgaris often develops due to inadequately treated pre-existing tuberculosis. It may also develop at site of BCG vaccination. [4]
  • It begins as painless reddish-brown nodules which slowly enlarge to form irregularly shaped red.

Diagnosis

Physical Examination

Skin

Extremity



Microscopic Pathology


Histologically, it shows well-formed granulomas with necrotic centers in dermis.

Differentiating Lupus vulgaris from other Diseases

The condition should be distinguished from:

Complications

In long standing scarred lesion, squamous cell carcinoma can develop.

Diagnosis

Physical Examination

Lupus vulgaris in a woman in the 19th century
Lupus vulgaris in a woman in the 19th century
Hyperkeratotic changes in the skin
Hyperkeratotic changes in the skin


Laboratory Findings

Diascopy

On diascopy, it shows characteristic "apple-jelly" color.

Biopsy

Biopsy will reveal tuberculoid granuloma with few bacilli.

Treatment

Medical Therapy

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).

References

  1. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. Chapter 74. ISBN 1-4160-2999-0.
  2. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
  3. "Lupus", Oxford English Dictionary, online second edition. Accessed 2006
  4. 4.0 4.1 4.2 Dermatology - A colour handbook, 2nd ed. Manson Publishing. 2010. p. 216. ISBN 9781840765960.
  5. 5.0 5.1 5.2 5.3 5.4 "Dermatology Atlas".

External Links

Template:Bacterial diseases

cs:Lupus vulgaris id:Lupus vulgaris


Template:WikiDoc Sources