Recurrent Papular Eruption: Answer

Abstract

The patient had papulonecrotic tuberculid as evidenced by a granulomatous dermal infiltrate seen in a biopsy from the erythematous papulonecrotic eruption. Interferon-gamma release assay (QuantiFERON Gold Plus, QIAGEN) was performed and found to be positive (TB1 4.23 IU/mL, TB2 5.52 IU/mL, and mitogen 6.34 IU/mL), indicating tuberculosis infection. The patient declined further invasive investigations to evaluate her cervical lymphadenopathy. She has since commenced antituberculous treatment with the improvement of her skin lesions and continues to follow-up at the National Tuberculosis Control Unit in Singapore.