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Klin Padiatr 2014; 226(01): 40-43
DOI: 10.1055/s-0033-1343412
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Two Cases of Lupus vulgaris in Childhood and Review of the Clinical Challenges

Zwei Fälle mit Lupus vulgaris im Kindesalter und ein Überblick über die klinische Problematik
A. K. Striegel
1   Children’s Hospital, University of Cologne, Germany
,
R. Nazzal
1   Children’s Hospital, University of Cologne, Germany
,
M. Fabri
2   Dermatology and Venerology, University of Cologne, Germany
,
E. Rietschel
1   Children’s Hospital, University of Cologne, Germany
,
J. Dötsch
1   Children’s Hospital, University of Cologne, Germany
,
C. Mauch
2   Dermatology and Venerology, University of Cologne, Germany
,
I. Tantcheva-Poor
2   Dermatology and Venerology, University of Cologne, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 April 2013 (online)

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Abstract

Background:

Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis (TB) in Europe, nevertheless the overall incidence is low. It constitutes about 1.5% of all extra-pulmonary cases worldwide. A slight raise in TB incidence rates among children was recently registered in Germany, which can be explained by the increased immigration.

Patients and Methods:

We present 2 cases of immigrated children who were diagnosed with Lupus vulagris, both clinically and histopathologically. Although the symptoms and the duration of the skin lesions were very different, both patients had a non-healing skin ulceration.

Results:

In our cases cultures of the skin biopsy were positive for Mycobacterium tuberculosis and the lesions showed marked improvement in response to antituberculous treatment. In the first patient, it took 6 years between occurrence of skin lesions and final diagnosis. The second patient had an extracutaneous focus, namely abdominal TB.

Conclusion:

We report our experience and emphasize on recent advances in the diagnosis and treatment of paediatric skin TB.

Zusammenfassung

Hintergrund:

Trotz insgesamt niedriger Inzidenz ist der Lupus vulgaris (LV) in Europa die häufigste Form der Hauttuberkulose. Weltweit liegt die Häufigkeit eines Lupus vulgaris bei 1,5% aller extrapulmonärer Tuberkulosen. Bei Kindern wurde in den letzten Jahren ein diskreter Anstieg der Tuberkuloseinzidenz beobachtet – dies ist als Folge einer gestiegenen Immigrationsrate ­erklärbar.

Patient und Methodik:

Wir stellen 2 immigrierte Kinder mit Lupus vulgaris vor. Die Diagnose wurde bei beiden sowohl klinisch als auch histopathologisch gestellt. Beide Patienten wiesen eine nicht heilende Hautulceraction auf, wobei sowohl die Symptome als auch die Dauer der Ulceration sehr unterschiedlich waren.

Ergebnisse:

In beiden Fällen waren die Kulturen der Hautbiopsien für Mykobacterium tuberculosis positiv und die Läsionen zeigten eine zunehmende Besserung unter tuberkulostatischer Therapie. Bei dem ersten Patienten betrug der Zeitraum vom Auftreten der Hautläsion bis zur Diagnosestellung 6 Jahre. Beim zweiten Patienten lag zusätzlich eine abdominelle Mitbeteiligung vor.

Schlussfolgerung:

Am Beispiel dieser beiden Fälle wollen wir unsere Erfahrungen berichten und jüngste Fortschritte in der Diagnosestellung und Therapie der Hauttuberkulose bei Kindern darstellen.

Key words

cutaneous tuberculosis - lupus vulgaris - scrophuloderm - tuberculosis cutis verrucosa

Schlüsselwörter

Hauttuberkulose - Lupus vulgaris - Scrophuloderma - Tuberculosis cutis verrucosa
 

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