Skin Tuberculosis presenting as a Tinea Incognito-like eruption: A case report

Lupus vulgaris is a progressive form of skin tuberculosis occurring in the patients with a moderate to high degree of immunity. It is reported to be the commonest type of skin tuberculosis. Our case was a 40 year-old man who referred with multiple, erythematous, annular plaques, 30-50 mm in diameter with active margin and few studded pustules throughout the lesions. Our first impression was tinea incognito so he received grisofulvin for one month, terbinafine and antibiotics (With diagnosis of chronic deep folliculitis and the presence of multiple pustules) each for two weeks but showed no response. Family history of tuberculosis, positive PPD test, presence of multiple giant cells and inflammatory infiltration around adnexa in histopathologic examination made the diagnosis of tuberculosis more possible. The patient was treated with anti-tuberculosis regimen. Improvement was noticed after 2 weeks and complete recovery occurred six months after treatment.