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Monthly QUIZ 

September 2003

Designed by;

O. Zargari , MD

Razi Hospital, Rasht, Iran

A 30-year-old woman presented with a long time history for  non-tender  lesions on her groins and thighs. She denied any  underlying lesion or trauma in the area.

Physical examination revealed multiple ulcerated nodular lesions and scarring adherent masses over the area in association with enlarged lymph nodes... 

What's your diagnosis and differentials?

Dx: Scrofuloderma

Scrofuloderma results from the involvement and breakdown of the skin overlying a tuberculous focus, usually a lymph gland but sometimes an infected bone or joint. The most common site is cervical region and less often the axillary, inguinal, epitrochlear and retro-auricular areas.

Clinically the lesions first manifest as blue-red, painless swellings overlying the infected glands and then break down to form undermined irregular ulcers in association with fistula formation. After healing, characteristic puckered scarring marks the site of the infection