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Lupus Vulgaris. Presented by Dr. Samuel Irgang.
A. P., a boy aged 9, a native of Puerto Rico but a resident of New York City for the past two years, is presented from Harlem Hospital with two coin-sized, sharply marginated, superficial, slightly infiltrated, crusted patches on the anterior and left lateral aspect of the neck. Lymphadenitis (possibly tuberculous) of the left cervical region requiring surgical intervention preceded the development of the lesions by several months.
An x-ray of the chest showed no abnormality of the lungs. An intracutaneous injection of 0.01 cc. of old tuberculin in a dilution of 1: 10,000 produced a moderately positive local reaction. Serologic tests of the blood for syphilis were negative. A hemogram was normal except for neutropenia (45%) and lymphocytosis (49%).
Histologic examination showed in the lower half of the cutis foci of miliary epithelioid tubercles with Langhans and foreign body giant cells.
Cipollaro AC, Miller JL. NEW YORK ACADEMY OF MEDICINE, SECTION OF DERMATOLOGY AND SYPHILIS. AMA Arch Derm Syphilol. 1953;67(3):331–336. doi:10.1001/archderm.1953.01540030094016