History: Lupus vulgaaris is the most common form of cutaneous tuberculosis that occurs in the tuberculin sensitive patients.  It is a chronic, progressive disease and has the most variable presentation.  The lesions usually are solitary, and more than 90% involve the head and neck.  Small, sharply marginated, red-brown papules of gelatinous consistency slowly evolve by peripheral extension and central atrophy into large plaques.  Lesions often persist for years before diagnosis and can be disfiguring.  In long-standing cases, squamous cell carcinoma can occur and be confused with the disease itself.