Papulonecrotic Tuberculid in a 9‐Year‐Old American Girl: Case Report and Review of the Literature

Abstract

Papulonecrotic tuberculid is a rare cutaneous manifestation of tuberculosis that can also be associated with other mycobacteria. Clinically, it is an asymptomatic, recurrent eruption of papules with a necrotic center in a symmetric, acral distribution. Tubercle bacilli are not present in skin biopsies. The eruption resolves promptly with antituberculoid therapy. Few patients with this entity have been reported in the United States over the last 50 years. We report a 9-year-old, otherwise healthy, American girl whose sole initial findings were lesions of papulonecrotic tuberculid secondary to Mycobacterium tuberculosis.

Papulonecrotic Tuberculid in a 2‐Year‐Old Girl: With Emphasis on Extent of Disease and Presence of Leucocytoclastic Vasculitis

“…The role of Mycobacterium tuberculosis and the interplay of vascular and hypersensitivity reactions in the pathogenesis and evolution of PNT have been the focus of interest and investigation in recent series (3,4,8). PNT in childhood has been documented rarely (4,9,10). Two aspects of the present patient expand the clinicopathologic spectrum of childhood PNT.…”

“…In 1980, Chavalittamrong et al (9) described PNT in a 12-yearold girl but did not comment on the presence or absence of vasculitis. A decade later, Sloan and Medenica (10) described PNT in a 9-year-old girl. They described lymphohistiocytic vasculitis in biopsied lesional tissue.…”

“…tuberculid (PNT) have been detailed in 10 patients. PNT is characterized by symmetric, acral papular lesions that undergo necrosis.…”

Papulonecrotic tuberculids: a rare cutaneous manifestation of tuberculosis in pregnancy

“…PNT has been described as a recurrent, symmetric eruption of papules with a necrotic centre, arising in crops, and most commonly involving the arms and legs 1 , 2. A hallmark of this condition is healing of the lesions with scarring and hyperpigmentation 3…”

In Reply

“…Although Kumar and Muralidhar (1) did not find any patients under the age of 10 years with tuberculids, three of their patients with tuberculids (some of which might have been EN) were in the 10–20‐year age group. In the experience of others and us, tuberculids are not uncommon in young children (5,14).…”