A rare case of Hodgkin’s lymphoma presenting with papulonecrotic tuberculid

Mishra, Kundan; Jandial, Aditya; Nambiyar, Kaniyappan; Malhotra, Pankaj

doi:10.1136/bcr-2017-220484

Cited by 1 publication

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“…23,24 There are cases of PNT associated with erythema nodosum, limb gangrene, Takayasu arteritis, arthritis, uveitis, optic neuritis, phlyctenular conjunctivitis, discoid lupus erythematosus, leucocytoclastic vasculitis, lymphadenopathy and Hodgkin lymphoma reported in the literature. 4,5,[25][26][27] et varioliformis acuta, lichen urticatus, insect bite, pruritus, prurigo, necrotizing leucocytoclastic vasculitis, suppurative folliculitis, secondary syphilis, miliary TB, infectious causes of palisade granuloma, perforating dermatoses and perforating granuloma annulare. 1,3,9,27 The salient clinical and histopathological features of diseases that can mimic PNT are shown in Table 1, and the differences between the various tuberculids are shown in Table 2.…”

Section: Associationmentioning

confidence: 99%

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Papulonecrotic tuberculid

Palaniappan

Sadhasivamohan

Karthikeyan

2022

Clinical and Experimental Dermatology

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A 30-year-old man presented with a 6 year history of recurrent, multiple asymptomatic raised lesions over his back and bilateral upper limbs. He had been treated repeatedly for a case of recurrent boils with oral and topical antibiotics. Some of the lesions had healed spontaneously leaving behind unsightly scars. The patient denied any history of associated fever, chronic cough, weight loss, and drug intake prior to the onset of lesions. There was no recognized contact with tuberculosis patients. General and systemic examination was essentially normal. Dermatological examination revealed the presence of multiple, well-defined, hyperpigmented crusted papules of 0.5-1.0 cm in size, distributed symmetrically over his entire back, extensor surface of bilateral forearm, arm, and bilateral dorsum of foot, interspersed with atrophic varioliform scarring (Figures 1 and 2). Routine laboratory workup was normal. Tuberculin (Mantoux) was strongly positive at 72 hours (23 × 23 mm) with central necrosis (Figure 3). Sputum for acid fast bacilli culture, chest radiograph, ultrasound abdomen, and pelvis did not reveal any abnormality. A biopsy specimen taken from a crusted papule over his forearm (Figure 4) showed fibrinoid necrosis, surrounded by mixed inflammatory infiltrate filling the entire dermis along with a few ill-defined epitheloid granulomas and lymphocytoclastic vasculitis. These are consistent with papulonecrotic tuberculid.The patient was started on a four drug combination therapy of rifampicin, isoniazid, pyrazinamide, and ethambutol for two months initially followed by a combination of rifampicin and isoniazid to complete a total of 6 months of standard antitubercular therapy. The patient responded well and all of the lesions eventually healed.

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Section: Associationmentioning

confidence: 99%

“…There are cases of PNT associated with erythema nodosum, limb gangrene, Takayasu arteritis, arthritis, uveitis, optic neuritis, phlyctenular conjunctivitis, discoid lupus erythematosus, leucocytoclastic vasculitis, lymphadenopathy and Hodgkin lymphoma reported in the literature 4,5,25–27 …”

Section: Associationmentioning

confidence: 99%