Korean J Dermatol.
1972 Jul;10(2):125-129.
A Case of Lichen Scrofulosorum
Abstract
- Lichen scrofulosorum, also known as Tuberculosis cutis lichenoides, is thought as a tuberculid such as Erythema induratum, Papulonecrotic tuberculid, Tuberculosis miliaris disseminata and Lupus miliaris disseminatus faciei. The lesions of Lichen scrofulosorum are pin-head sized or smaller, normal skin or reddish brown colored, arranged in nummular groups, usually on the trunk, where they persist unchanged or undergo spontaneous involution. As a rule, they appear in children who have tuberculosis of the bones or the lymphnodes. We report a case of Lichen scrofulosorum, 13-year old girl, who showed clinically and histologically typical lesions on the trunk. She was highly sensitive to Mantoux test and had tuberculous lymphadenitis of left cervical lymphnodes, but the chest was negative. Many challenges to the tuberculous origin of the tuberculids including Lichen scrofulosorum have prevailed for the last decade, Several studies and reports indicated that healing responses of Erythema induratum and other tuberculids to corticosteroids were more definite than to anti-tuberculosis drugs. But more recently, some reports recommended that anti-tuberculosis drugs were eftective than corticosteroids (in the treatment of Erythema induratum and other tuberculids). In this case anti-tuberculosis treatment with PAS 10gm., INH 400 mg., and streptomycin 1.0 gm. daily for the first one month and then 1.0gm. twice a week has remarkably improved the clinical manifestation in follow-up of three months. While the follow-up period was no enough, we strongly suggest the tuberculous origin of Lichen scrofulosorum.
