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Han, Kim, Kwak, Choi, Shin, Kim, Park, Kim, and Choi: A Case of Tuberculous Lymphadenitis accompanying Papulonecrotic Tuberculid
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(6): 536-539.

Published online: 30 June 2007

DOI: https://doi.org/10.4046/trd.2007.62.6.536

A Case of Tuberculous Lymphadenitis accompanying Papulonecrotic Tuberculid

Tae Young Han, M.D.2, Ji Young Kim, M.D.2, Hee Won Kwak, M.D.1, Jae Chul Choi, M.D.1, Jong Wook Shin, M.D.1, Jae Yeol Kim, M.D.1, In Won Park, M.D.1, Meyung Nam Kim, M.D.2, Byoung Whui Choi, M.D.1

1Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.

2Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.

Address for correspondence: Jong Wook Shin, M.D. Division of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, 224-1, Huksuk-dong, Dongzak-gu, Seoul, 156-756, Korea. Phone: 82-2-6299-1407, Fax: 82-2-823-1049, basthma@hanmail.net, basthma@cau.ac.kr

Received 3 May 2007       Accepted 14 May 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Lymphadenitis is a common manifestation in tuberculous diseases. However, papulonecrotic tuberculid is an uncommon cutaneous manifestation, and is considered an allergic reaction against tuberculous bacilli in tuberculous lesions other than the lymph nodes. A wide great variety of cutaneous manifestations arise over a period of a few weeks - i.e., papules, necrosis, crusted and atrophic scars. We described a 27-year-old woman with right cervical tuberculous lymphadenitis and skin lesions involving her arms, legs and both fingers. Histopathologically, a leukocytoclastic vasculitis with V-shaped epidermal necrosis was observed in the upper and deep dermis, including the good response to anti-tuberculosis therapy support the diagnosis of papulonecrotic tuberculid.

Keywords: Papulonecrotic tuberculid, Tuberculous lymphadenitis

Figures and Tables

Figure 1
Erythematous crusted papules on the both forearm, knee and fingers.
trd-62-536-g001
Figure 2
A) V shaped necrosis on the epidermis (H&E stain, ×40). B) Leukocytoclastic vasculitis on the dermal vessel (H&E stain, ×200)
trd-62-536-g002

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