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<p>This report describes a rare case of lupus vulgaris mimicking psoriasis, undiagnosed for over 40 years. Conventional diagnostics, including histopathology and mycobacterial culture, failed to yield a definitive diagnosis. Ultimately, metagenomic next-generation sequencing (mNGS) of the skin tissue detected the <i>Mycobacterium tuberculosis</i> complex, confirming the infection. The patient showed marked clinical improvement following two months of dual-drug anti-tuberculosis therapy. This case highlights the clinical utility of mNGS for diagnosing atypical, long-standing cutaneous tuberculosis when conventional methods are negative, thereby preventing prolonged misdiagnosis and ensuring timely treatment.</p>

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A rare case of long-standing lupus vulgaris with psoriasiform manifestations diagnosed by mNGS: a case report

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Qiang Li,
  • Xiaoyang Yang,
  • Huanlin Zhu,
  • Shuhui Yang,
  • Guangwen Yin

摘要

This report describes a rare case of lupus vulgaris mimicking psoriasis, undiagnosed for over 40 years. Conventional diagnostics, including histopathology and mycobacterial culture, failed to yield a definitive diagnosis. Ultimately, metagenomic next-generation sequencing (mNGS) of the skin tissue detected the Mycobacterium tuberculosis complex, confirming the infection. The patient showed marked clinical improvement following two months of dual-drug anti-tuberculosis therapy. This case highlights the clinical utility of mNGS for diagnosing atypical, long-standing cutaneous tuberculosis when conventional methods are negative, thereby preventing prolonged misdiagnosis and ensuring timely treatment.