A Rare Case of Lupus Vulgaris in a Private Tertiary Health Facility in South-Western Nigeria

Background: Lupus Vulgaris is the most common form of cutaneous tuberculosis. It represents a reactivation of infection in people with moderate to high immunity against mycobacterium tuberculosis. Lesions can develop in all ages, as a collection of discrete, red-brown papules that subsequently coalesce to form an indolent asymptomatic plaque on the affected site. Diagnosis constitutes a major challenge as the most definitive investigative modality, mantoux test is not always positive. Histological examination and initiation of antitubercular therapy usually leads to diagnosis and clinical cure respectively.

Objective: We report a case of Lupus Vulgaris of external nose, a rare, underreported and commonly misdiagnosed condition in Nigeria.

Case Report: A 13-year-old female presented with proliferative, raised multinodular lesion over the external nose. Clinical features, histopathological examination and a strongly reactive tuberculin skin test were all supportive of a diagnosis of Lupus Vulgaris. Antitubercular therapy (9-month regimen) was started and later followed by serial debridement of necrosed tissue. The lesion significantly resolved.