A Rare Case of a Lichenoid Rash with Granulomatous Histology

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A Rare Case of a Lichenoid Rash with Granulomatous Histology

K Mahmood*, L Nemazee**, N J Innes***
*Department of Dermatology, Ipswich Hospital NHS Trust, **Medical Trainee, Ipswich Hospital NHS Trust, ***Department of Respiratory Medicine, Ipswich Hospital NHS Trust


Lichen Scrofulosorum, otherwise known as Tuberculid, is a hypersensitivity reaction to mycobacterium tuberculosis. It is a rarely seen pathology and it presents with a lichenoid rash and a granulomatous picture is seen on histology.
We present the case of a 72 year old man with a background of pleural and renal Tuberculosis, who presented with a 10 month history of lichenoid papules, widespread over the trunk and limbs. Skin biopsy showed granulomatous inflammation. This clinical picture and histology, together with a background of tuberculosis in the past, was highly suggestive of Lichen Scrofulosorum.
Although tuberculid occurs rarely, it may be the only marker of occult TB and which may not be dis-covered otherwise. Therefore it is important that skin physicians are able to detect and diagnose tuberculid and so treat accordingly.
Keywords: Lichen Scrofulosorum,Tuberculid ,Cutaneous Tuberculosis


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