An unusual case of vulval papulonecrotic tuberculid

Abstract

The tuberculids are a group of rare cutaneous hypersensitivity reactions that occur in response to a distant focus of mycobacterial infection. Typically, Mantoux testing is strongly reactive, and clinical response to antituberculous treatment is rapid. The papulonecrotic subtype is one such clinical variant, consisting of multiple symmetrical papules, often with central necrosis, distributed preferentially over the trunk and limbs. Localized forms are rare, and mainly involve the genitalia in men. We describe a 26-year-old Indian woman with lymphatic and pulmonary tuberculosis (TB) in association with localized papulonecrotic tuberculid of the vulva, which resolved promptly on treating the underlying TB.

Woody Vulva: An Unusual Presentation of Vulvar Tuberculosis

“…The gross appearance of vulvar tuberculosis is varied, ranging from ulcerative lesions, discharging sinuses, elephantiasis and esthiomene, lymphedema, or grossly hypertrophic lesions [6][7][8][9]. No age is immune from this rare disease.…”

Cutaneous tuberculosis: epidemiologic, etiopathogenic and clinical aspects - Part I

“…22,23,40 Recurrences are common without tuberculostatic treatment, however when drugs are introduced, it is possible to observe clinical improvement in a few days or weeks. 41 …”

Vulvar infections: beyond sexually transmitted infections

“…When symptoms are evident, it can present with thickening and darkening of the vulvar skin and can also be associated with swelling, pruritic rash, and narrowing of the introitus . Ulceration, necrotic lesions, sinus tracts, and lymphedema have also been reported . In rare cases, it may be mistaken for a tumor .…”

“…In rare cases, it may be mistaken for a tumor . Inguinal lymphadenopathy may accompany vulvar changes . The upper genital tract often becomes involved, which may lead to pelvic inflammatory disease and even infertility .…”