Presumed periorbital lupus vulgaris with ocular extension

Objective: To report an unusual case of lupus vulgaris that spread to the left anterior ocular surface. Design: Case report. Participant: An 18-year-old woman presented with an 8-month history of an infiltrative skin lesion affecting the left tower eyelid and cheek area, left globe, right lacrimal sac area, together with a cystic lesion in the foot area. Testing/Intervention: The authors describe the clinical findings, radiologic study, and histopathologic study of the conjunctiva, skin, liver, and ankle lesion. The patient was treated with antituberculous medications for 3 months. Main Outcome Measure: Healing of the skin, conjunctival, and bone lesions. Results: The lesion of the face healed, leaving scar tissue. The left eye showed symblepharon with loss of its anterior surface features. The right eye showed no symblepharon, the bones of the foot healed with no deformity, and the liver function test results normalized after 3 months of antituberculous medications. Conclusion: Lupus vulgaris can be associated with multiple system involvement. Its clinical presentation and behavior depend on the patient's immunity and duration of the disease. Early diagnosis and appropriate management may cure the disease with no rife-threatening sequelae.