Papulonecrotic tuberculid a case report

Introduction: Papulonecrotic tuberculid (PNT) is a chronic, recurrent, and symmetric eruption of necrotising skin papules in crops involving the arms and legs, and healing with scar formation. PNT is an uncommon disorder, occurring in less than 5 % of cases of active TB. The pathophysiology of this disease has remained controversial. Case: A 31 years old Balinese woman, visited Outpatient Clinic Department of Dermatology and Venereology Sanglah Hospital Denpasar in 8th September 2003, she has complained of recurrent ulcer for 14 years ago. The clinical feature showed papules, multiple ulcer, and scars, symmetrically on her arms, legs and trunk. Mantoux skin test was strongly positive with 13 mm induration. Lymphohystiocytic vasculitis was found on cell pathology examination, there is no evidence of microbial growth in culture, Ziehl-Neelsen staining and PCR was negative. She was given antituberculosis with a rapid improvement after therapy for 6 months with no significant adverse event. Conclusion: Treatment for six months using anti-tuberculosis drugs provides satisfactory results with clinical improvement in patients with PNT.