lupus vulgaris is the most common morphological presentation of cutaneous tb that can present as papular , nodular , plaque , ulcerative , vegetating , and tumid forms .
it often originates from an underlying focus of tb , typically in a bone , joint or lymph node , and spreads by either contiguous extension of the disease from underlying affected tissue , or by hematogenous or lymphatic spread .
it is a paucibacillary type of cutaneous tb and occurs in a patient of a moderate immunity .
a typical feature of lupus vulgaris is its extremely chronic course , characterized by a slow and steady growth of the lesion over a period of years .
unusual variants include the frambesiform , gangrenous , ulcerovegetating , lichen simplex chronicus , myxomatous , and sporotrichoid types . herein we report a rare sporotrichoid presentation of the disease .
a 28-year - old female with family history of tb presented with multiple , asymptomatic , raised skin lesions of variable size and shape over her right lower limb .
lesions first appeared on the upper surface of her right foot 12 years ago [ figure 1 ] after a thorn prick .
thereafter , they extended steadily upward to her inner thigh , increasing both in number and size .
there was a history of scarring at one end of the lesions and extension from the other .
examination of the right lower limb revealed polysized plaques of 4 - 8 cm diameter with central scarring and peripheral nodularity extending in a linear array from the dorsum of the lateral three toes to the medial aspect of ankle joint , knee joint , and medial aspect of the upper thigh in a sporotrichoid pattern [ figure 2 ] .
histopathology revealed hyperkeratosis , acanthosis and elongation of the rete ridges with dense dermal granulomas comprising epithelioid cells , langhan 's type giant cells and chronic inflammatory cells , supporting a diagnosis of lupus vulgaris [ figure 3 ] .
plaque from dorsum of the foot in a sporotrichoid pattern plaque in sporotrichoid pattern histopathology showing granulomas comprising epitheloid cells and langhan 's type giant cells ( h and e stain , 40 ) a final diagnosis of sporotrichoid - lupus vulgaris was made and the patient referred to the government tb clinic for category i dots .
sporotrichoid form of lupus vulgaris is an unusual variant that mimics sporotrichosis , a subcutaneous fungal disease .
bacilli follow the lymphatic channels and during transit , provoke cutaneous granulomatous inflammation resulting in a linear array of papular , nodular and ulcerative lesions over time .
it has been shown that sporotrichoid form is more common in children than in adults .
the efficient lymphatic drainage in children and high physical activity that makes them prone to trauma may be responsible for this form . as it is a complex process and takes time
 lupus vulgaris is the most common presentation of cutaneous tuberculosis in india and can present as papular , nodular , plaque , ulcerative , vegetating , and tumid forms . 
 unusual variants include the frambesiform , gangrenous , ulcerovegetating , lichen simplex chronicus , myxomatous , and sporotrichoid types . 
 we describe a rare sporotrichoid presentation of lupus vulgaris on the leg of a 28-year - old female of 12 years duration . 
INTRODUCTION
CASE REPORT
DISCUSSION