A 10-year-old child presents with asymptomatic, grouped, follicular papules on the trunk. The child has strongly positive Mantoux test and underlying tuberculous lymphadenitis. Biopsy of a papule shows non-caseating granulomas around hair follicles. What is the most likely diagnosis?
- A Lichen scrofulosorum ✓
- B Papulonecrotic tuberculid
- C Lupus vulgaris
- D Scrofuloderma
Correct answer: A. Lichen scrofulosorum
Explanation
Lichen scrofulosorum is a tuberculid presenting with asymptomatic grouped follicular papules on the trunk in children with strong tuberculin sensitivity and an underlying TB focus. Histopathology characteristically shows non-caseating granulomas around hair follicles. Papulonecrotic tuberculid presents with necrotic papules on extensors. Lupus vulgaris and scrofuloderma are true cutaneous TB forms showing caseating granulomas and are not classified as tuberculids.
Reference: IADVL Textbook of Dermatology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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