Papulonecrotic tuberculid--a rare skin manifestation in a patient with pulmonary tuberculosis

Papulonecrotic tuberculid (PNT), a cutaneous manifestation of tuberculosis, is rare even in areas endemic for tuberculosis such as Taiwan. Concomitant pulmonary tuberculosis is uncommon in patients with PNT. We describe a patient with rare skin manifestations and simultaneous pulmonary tuberculosis. This 48-year-old woman had suffered from productive cough for 4 months, and pea-sized papules with central umbilication were noted over the extensor surface of her four extremities and lower abdomen 1 month prior to admission to our hospital. Chest roentgenography showed reticulonodular lesions with small cavitation over the lower right lung field, and sputum culture yielded Mycobacterium tuberculosis complex. PNT was diagnosed using the skin biopsy results and the papules healed with scar formation after antituberculous therapy.