Papulonecrotic Tuberculid: A Rare Case Report
They are currently believed to be the result of hematogenous dissemination of organisms
from an internal focus to the skin, where they incite
a cutaneous inflammatory response.
Papulonecrotic tuberculid is a form of tuberculids that as the name implies presents
clinically as necrotic papules. Herein, we report a case of 59-year-old man who presented
with recurrent asymptomatic symmetrical necrotizing papules scattered on his trunk for 9 months.
The patient has also crusted plaque on his right forearm. Two skin biopsies were made,
one from papulonecrotic lesion on his trunk and the other one from the crusted plaque on his right forearm.
The crusted plaque on the forearm showed granulomatous cellular infiltrates and caseation
necrosis in the dermis, whereas the papulonecrotic lesions showed patchy perivascular mononuclear cellular infiltrates as well as granulomatous cellular infiltrates in the dermis.
Mycobacterium tuberculosis culture from tuberculid is of low yield. Papulonecrotic tuberculid
is a form of tuberculids that as the name implies presents clinically as necrotic papules.
Tuberculid was first described by Darrier in 1896. It represents an Arthus reaction
accompanied by delayed-type hypersensitivity reaction.
A 59-year-old man presented with 9 months history of recurrent asymptomatic skin lesions.
The lesions last for 1-2 months then disappear spontaneously without treatment but recur again
Dermatol Open J. 2017; 2(1): 1-3. doi: 10.17140/DRMTOJ-2-118
