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Lupus Vulgaris. Presented by Dr. Norman E. Levan and Dr. Joseph Rapaport by invitation.
Patient.—A 57-year-old married Caucasian housewife, she was born in Lebanon (Armenian ancestry).
Present Illness.—Forty-five years ago this patient visited Aleppo, Syria, with her family. Several members of the family developed "Aleppo boil," and the patient developed a lesion on her face. This facial lesion seemed to improve and healed partially at times, but over the past 45 years it has gradually increased in size and has been intermittently active.
The patient has been treated by various doctors at the Good Hope Clinic since 1946, where the diagnoses of cutaneous leishmaniasis and lupus vulgaris were entertained.
Physical Examination.—Multiple atrophic cicatricial lesions with brown to yellowish white, slightly raised nodules in the periphery are present. On the right cheek there is a small, shallow ulceration within a scar.
Laboratory.—PPD 1st strength test was 4+