The tuberculids represent a group of disorders resulting from hypersensitive immune reactions within the skin due to hematogenous dissemination of Mycobacterium tuberculosis or its antigens from a primary source. Erythema induratum of bazin, papulonecrotic tuberculid and lichen scrofulosorum are classified as true tuberculids. Tuberculids are rare manifestation and simultaneous occurrence of two tuberculids in one patient is even rarer. We report a case of 25 year lady presenting with erythema induratum and papulonecrotic tuberculid simultaneously. Though no source of active infection was found, her lesions were found to be consistent with the diagnosis clinicopathologically and resolved with antitubercular treatment. Concomitant occurrence of two tuberculids in one patient is a rare manifestation and when this has been reported, the commonest combination appeared to be erythema induratum of bazin and papulonecrotic tuberculid, similar to our case, which resolved with antitubercular treatment.
Paraneoplastic pemphigus (PNP) is a rare autoimmune disorder associated with underlying benign or malignant neoplasia. Its signs and symptoms may be the first presentation of a concealed malignancy. Due to late diagnosis, prognosis of PNP is not good, so early diagnosis and treatment is of paramount importance. We present a case of 22 years old female who presented to our out patient department (OPD) with history of recurrent, severe, recalcitrant, painful oral ulcers; lichenoid lesions over the hands and feet and widespread blistering and erosions involving the soles. Histopathological examination was consistent with paraneoplastic pemphigus and showed features of lichenoid dermatitis. CT scan revealed retroperitoneal mass suggestive of Castleman disease. The patient was referred to surgical team for further management.
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