Lupus Vulgaris : Understanding the Cause, Occurrence, Treatment, and Medications.
Systemic lupus erythematosus (SLE) and Lupus Vulgaris these disease conditions apear very similar while the cause is different systenic lupus erythematosus is an autoimmune disease while Lupus Vulgaris is caused by infection of Mycobacterium tuberculosis.
Lupus vulgaris is a chronic skin condition characterized by the formation of reddish-brown plaques with distinct borders. This type of tuberculosis infection primarily affects the skin and occurs due to the bacterium Mycobacterium tuberculosis. We will discuss the cause of Lupus vulgaris, how it occurs, its treatment options, and the medications commonly used to manage the condition. Additionally, we will discuss dosages, potential side effects, and contraindications of these medications.
Cause and Causative Microorganism:
Lupus vulgaris is a secondary form of tuberculosis that occurs as a result of the reactivation of dormant Mycobacterium tuberculosis present in the body. The bacteria gain entry through inhalation, primarily affecting the lungs during the initial infection. However, they can also reach the skin through the bloodstream and lymphatic system, leading to cutaneous tuberculosis, including LV.
How it Occurs?
The development of Lupus vulgaris begins when the dormant Mycobacterium tuberculosis bacilli become reactivated, triggered by factors like immune system compromise, malnutrition, or other underlying health conditions. The bacteria multiply and form small nodules in the dermis, leading to the characteristic reddish-brown plaques on the skin’s surface. Over time, these plaques may enlarge and spread, causing further skin damage if left untreated.
Treatment Options:
The treatment of Lupus vulgaris involves a combination of anti-tuberculosis medications and sometimes surgical interventions. Early diagnosis and prompt treatment are crucial to prevent the spread of the infection and tissue destruction.
Medications Used for Treatment of Lupus Vulgaris:
1. Isoniazid (INH): A primary drug used in the treatment of tuberculosis, including this LV. It inhibits bacterial cell wall synthesis and is typically administered at a dosage of 300 mg once daily.
2. Rifampicin (RIF): Another essential drug in the anti-tuberculosis regimen, Rifampicin inhibits bacterial RNA synthesis. It is usually prescribed at a dosage of 600 mg once daily.
3. Ethambutol (EMB): Ethambutol is used to prevent bacterial growth by affecting the synthesis of the cell wall. The typical dosage is 15-25 mg/kg body weight once daily.
4. Pyrazinamide (PZA): This drug has bactericidal effects and is used to eradicate dormant bacteria. It is commonly prescribed at a dosage of 15-30 mg/kg body weight once daily.
Side Effects of Medications:
While anti-tuberculosis medications are generally effective, they can cause side effects that require careful monitoring:
Isoniazid: Side effects may include liver toxicity, peripheral neuropathy, and gastrointestinal disturbances.
Rifampicin: Common side effects include gastrointestinal upset, orange discoloration of body fluids, and liver enzyme abnormalities.
Ethambutol: Possible side effects include optic neuritis leading to visual disturbances and hyperuricemia.
Pyrazinamide: Side effects may include liver toxicity, gastrointestinal upset, and joint pain.
Contraindications:
Certain medical conditions and medications may interact negatively with anti-tuberculosis drugs. Contraindications include:
Known hypersensitivity or severe adverse reactions to any of the anti-tuberculosis medications.
Pre-existing liver or kidney disease.
Co-administration with certain medications, such as anticoagulants, anti-epileptics, and antiretroviral drugs.
Inferance: Lupus vulgaris, a form of cutaneous tuberculosis caused by Mycobacterium tuberculosis, requires early diagnosis and prompt treatment to prevent skin damage and further complications. The combination of anti-tuberculosis medications, including Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide, plays a crucial role in managing the condition. However, healthcare providers should carefully monitor patients for potential side effects and contraindications to ensure a successful treatment outcome. Timely intervention and adherence to the prescribed treatment plan are key factors in the effective management.
Referances: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923933/