Primary Lid Tuberculosis Occuring at Preaponeurotic Portion after upper Lid Blepharo plasty

ABSTRACT

Tuberculosis of the lid is a rare disease that usually extends directly from surrounding tissues such as paranasal sinuses and lacrimal glands, or occurs possibly as a result of hematogenous spread. Primary tuberculous infection of lid also rarely occurs. The earliest lesion is a brownish red, soft papule that develops into an indurated nodule or plaque that may ulcerate. There is usually prominent lymphadenopathy. The diagnosis is established through tuberculin skin testing, stains for acid-fast organisms, and cultures. If diagnosis is delayed, complications including extensive orbital tissue damages, cold abscess, cutaneous fistula, and cicatricial ectropion may ensue. Lid tuberculosis should be differentiated from other granulomatous lesions of eyelid and also from other more commonly occuring orbital tumors. The combination therapy of Isoniazid, Rifampin, and Pyrazinamide is recommended for lid tuberculosis. We experienced a patient presenting with painless upper eyelid nodule that occurred about 3 weeks following upper lid blapharoplasty and treated her with anti-tuberculous medications after histological diagnosis of lid tuberculosis has been made. So, we report this rare case of lid tuberculosis with literature.