[A Case of Cutaneous Tuberculosis is Simulating Paraneoplastic Vasculitis]

Area of Science:

• Oncology
• Infectious Diseases
• Dermatology

Context:

• A patient with a history of T-cell non-Hodgkin lymphoma achieved clinical remission following chemotherapy and radiotherapy.
• The patient presented with hemorrhagic and necrotic skin lesions on the right hand, raising suspicion for paraneoplastic vasculitis.

Purpose:

• To report a rare case of disseminated tuberculosis mimicking paraneoplastic vasculitis in an immunocompromised patient.
• To highlight the importance of considering infectious etiologies in patients with unusual skin manifestations, even during cancer remission.

Summary:

• Diagnostic workup, including complementary testing, revealed disseminated tuberculosis with both skin (cutaneous miliary tuberculosis) and lung involvement.
• The patient received anti-tuberculosis treatment, leading to a satisfactory resolution of the presenting symptoms and signs.

Impact:

• This case underscores the diagnostic challenge posed by atypical presentations of tuberculosis in patients with a history of malignancy.
• It emphasizes the need for a broad differential diagnosis, including infectious diseases, in patients with cutaneous lesions suggestive of vasculitis.