Papulonecrotic tuberculids: a rare cutaneous manifestation of tuberculosis in pregnancy

A 31-year-old Moroccan woman with no significant past medical history was seen during her second pregnancy. At 25 weeks gestation she was admitted with a febrile illness associated with a productive cough which was treated as a community acquired pneumonia with oral antibiotics. At 31 weeks gestation she was admitted with a tender swelling in the right groin and underwent incision and drainage of a presumed femoral abscess. At 36 weeks gestation she re-presented with multiple skin lesions on her arms, legs and buttocks. Initial investigation found no obvious cause for her presentation. The decision for induction of labour was taken as the patient was not improving, and resulted in an uncomplicated Caesarean delivery. After delivery, Mantoux and Quantiferon tests were reported to be positive and the patient was diagnosed with papulonecrotic tuberculides.