A 45-Year-Old Woman With 30-Year History of a Nodule of the Earlobe Diagnosed as Lupus Vulgaris (Cutaneous Tuberculosis).
- 1Department of Dermatology, The Fifth People's Hospital of Suzhou, Suzhou, Jiangsu, China.
- 2Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Abstract
BACKGROUND Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis, which can affect multiple organs in the human body. Lupus vulgaris is the most common clinical type of cutaneous tuberculosis in China. It typically follows a chronic course, with skin lesions that are difficult to heal, making it prone to misdiagnosis and missed diagnosis. This report presents a case of chronic lupus vulgaris that remained untreated over an exceptionally long duration, demonstrating that lupus vulgaris can manifest as a chronic inflammatory focus. CASE REPORT This article reports a case of a 45-year-old woman with a rash on her right earlobe for more than 30 years without pain, with occasionally itching. The rash presents as a red, thickened plaque with yellow papules and pustules on the surface. She sought treatment at hospitals and completed a few examinations. The histopathology revealed multiple epithelioid cell clusters surrounded by dense lymphocytic and histiocytic infiltration in the dermis. The interferon gamma release assay was positive. The Xpert test was positive for Mycobacterium tuberculosis. Mycobacterial culture and acid-fast staining were positive, and the cultured organism was identified as Mycobacterium tuberculosis. The chest computed tomography showed a previous lesion in the right upper lobe. Based on these findings, the diagnosis was confirmed as lupus vulgaris on the right earlobe. After anti-tuberculosis therapy, the skin lesions improved significantly. CONCLUSIONS The case showed that patients with persistent skin lesions, nodules, or ulcers, particularly responding poorly to treatment, should undergo appropriate examinations to rule out cutaneous tuberculosis, including lupus vulgaris.
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BibTeX
@article{zhang202645yearold,
title = {{A 45-Year-Old Woman With 30-Year History of a Nodule of the Earlobe Diagnosed as Lupus Vulgaris (Cutaneous Tuberculosis).}},
author = {Xiaoyan Zhang and Yating Xu and Linyi Song and Minzhi Wu},
journal = {The American journal of case reports},
year = {2026},
month = oct,
doi = {10.12659/ajcr.954366},
url = {https://europepmc.org/article/MED/42842519},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A 45-Year-Old Woman With 30-Year History of a Nodule of the Earlobe Diagnosed as Lupus Vulgaris (Cutaneous Tuberculosis).
AU - Xiaoyan Zhang
AU - Yating Xu
AU - Linyi Song
AU - Minzhi Wu
PY - 2026
DA - 2026/10/07
JO - The American journal of case reports
DO - 10.12659/ajcr.954366
UR - https://europepmc.org/article/MED/42842519
AB - BACKGROUND Tuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis, which can affect multiple organs in the human body. Lupus vulgaris is the most common clinical type of cutaneous tuberculosis in China. It typically follows a chronic course, with skin lesions that are difficult to heal, making it prone to misdiagnosis and missed diagnosis. This report presents a case of chronic lupus vulgaris that remained untreated over an exceptionally long duration, demonstrating that lupus vulgaris can manifest as a chronic inflammatory focus. CASE REPORT This article reports a case of a 45-year-old woman with a rash on her right earlobe for more than 30 years without pain, with occasionally itching. The rash presents as a red, thickened plaque with yellow papules and pustules on the surface. She sought treatment at hospitals and completed a few examinations. The histopathology revealed multiple epithelioid cell clusters surrounded by dense lymphocytic and histiocytic infiltration in the dermis. The interferon gamma release assay was positive. The Xpert test was positive for Mycobacterium tuberculosis. Mycobacterial culture and acid-fast staining were positive, and the cultured organism was identified as Mycobacterium tuberculosis. The chest computed tomography showed a previous lesion in the right upper lobe. Based on these findings, the diagnosis was confirmed as lupus vulgaris on the right earlobe. After anti-tuberculosis therapy, the skin lesions improved significantly. CONCLUSIONS The case showed that patients with persistent skin lesions, nodules, or ulcers, particularly responding poorly to treatment, should undergo appropriate examinations to rule out cutaneous tuberculosis, including lupus vulgaris.
SN - 1941-5923
ER -