Lupus Vulgaris — SCE Infectious Diseases MCQ
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Correct answer: E — Send fresh tissue for mycobacterial culture and molecular testing while correlating histology, exposure and systemic assessment with review after review
The best answer is “Send fresh tissue for mycobacterial culture and molecular testing while correlating histology, exposure and systemic assessment with review after review”. Cutaneous TB is paucibacillary and requires integrated microbiology and histology; morphology alone is not sufficiently specific. “Diagnose leprosy without sensory examination or species testing” does not match the decisive clinical feature or cited guidance. “Call it a foreign-body granuloma despite acid-fast organisms” does not match the decisive clinical feature or cited guidance. “Diagnose sarcoidosis because granulomas are present” does not match the decisive clinical feature or cited guidance. “Use leishmania serology alone” does not match the decisive clinical feature or cited guidance.
Reference: NICE NG33 tuberculosis recommendations: https://www.nice.org.uk/guidance/ng33/chapter/Recommendations