Lupus vulgaris with Schaumann bodies – An atypical histopathological finding

Lupus vulgaris with Schaumann bodies

Abstract

  Introduction: Lupus vulgaris is a progressive form of cutaneous tuberculosis occurring in a person with moderate to high degree of immunity. Schaumann bodies are commonly seen in sarcoid granulomas but can be rarely be seen in other conditions. We report a case of lupus vulgaris with Schaumann bodies which is an atypical histopathological finding. Case Description: Our case is an 11year old female with a single erythematous plaque over right knee since 3years. She was a term normal birth weight child born out of non-consanguineous marriage. On general examination child appeared normal. On cutaneous examination single asymmetrical erythematous scaly plaque of size 8*6 cm is seen which is not associated with any systemic symptoms.  No other lesions over the body. Routine blood investigations, CXR were normal USG abdomen showed few non-specific mesenteric LN of size 13*7cm. Mantoux test is positive (14TU PPD). Histopathological confirmation: The epidermis displays irregular acanthosis. Within the superficial and deep dermis there is a dense, granulomatous infiltrate composed of numerous lymphocytes, epithelioid histiocytes and Langerhans giant cell which clinched the diagnosis of lupus vulgaris Focally Schaumann bodies are also seen. Conclusion: Based on clinical features and with the help of histopathological examination we confirmed the case as lupus vulgaris. Though Schaumann bodies are commonly seen in sarcoid granulomas, but can be rarely seen in granulomas due to other causes, especially tuberculosis.