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| Fig. 30.5 Scrofuloderma. Erythematous to violaceous nodule with ulceration. The lesion is an extension from an underlying lymph node. |
Scrofuloderma is a form of cutaneous tuberculosis that originates in tuberculous lymph nodes, bones, joints, or epididymis and spreads directly to the overlying skin. The most common locations include the lateral neck and the parotid, submandibular, and supraclavicular areas. The skin lesion presents as a firm subcutaneous nodule. As the lesion matures, there is extensive necrosis leading to a soft, doughy consistency, ulceration with bluish margins, and formation of a sinus tract. Necrotic cheesy material may drain from sinus tracts (Fig. 30-5).
