Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients

Background: Papulonecrotic tuberculid (PNT) is said to be a hypersensitivity reaction to M. tuberculosis. Some reports indicate that organisms are demonstrable by polymerase chain reaction (PCR). Methods: We describe 12 patients with PNT over 6 years. We reviewed the histopathologic features, cl...

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Autores principales:	Rajalakshmi Tirumalae, Inchira K. Yeliur, Meryl Antony, Geojith George, John Kenneth
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2014
Materias:	cutaneous tuberculosis papulonecrotic tuberculid Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/2d1c360b764f4477b815cadb33a6f0ce
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spelling	oai:doaj.org-article:2d1c360b764f4477b815cadb33a6f0ce2021-11-17T08:32:23ZPapulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients10.5826/dpc.0402a032160-9381https://doaj.org/article/2d1c360b764f4477b815cadb33a6f0ce2014-04-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/878https://doaj.org/toc/2160-9381 Background: Papulonecrotic tuberculid (PNT) is said to be a hypersensitivity reaction to M. tuberculosis. Some reports indicate that organisms are demonstrable by polymerase chain reaction (PCR). Methods: We describe 12 patients with PNT over 6 years. We reviewed the histopathologic features, clinical data and follow-up. PCR for M. tuberculosis DNA was done in all cases. Results: There were 7 men and 5 women. The ages ranged from 3-58 years. Upper limbs were commonly involved (8 cases). All patients had multiple papulonodular lesions, 5 showed ulceration and scarring. Mantoux test was strongly positive in all. Seven patients had systemic tuberculosis. On microscopy, necrosis was seen in 11 cases, varying from minimal to extensive. Epithelioid granulomas were common, except for 1 case with palisading and interstitial patterns. The infiltrate showed mostly lymphocytes, while 3 cases showed eosinophils. Vasculitis was seen in 8 cases. Two cases had dermal mucin, one also with interface dermatitis. This patient had concurrent LE. Mycobacterial DNA was detectable by PCR in 3 cases. Seven patients showed improvement/resolution of lesions on treatment. Conclusions: PNT is a rare disease. A positive PCR reiterates the question whether these are “tuberculids”. PNT may be better classified as true cutaneous tuberculosis and patients screened for systemic disease. Rajalakshmi TirumalaeInchira K. YeliurMeryl AntonyGeojith GeorgeJohn KennethMattioli1885articlecutaneous tuberculosispapulonecrotic tuberculidDermatologyRL1-803ENDermatology Practical & Conceptual (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	cutaneous tuberculosis papulonecrotic tuberculid Dermatology RL1-803
spellingShingle	cutaneous tuberculosis papulonecrotic tuberculid Dermatology RL1-803 Rajalakshmi Tirumalae Inchira K. Yeliur Meryl Antony Geojith George John Kenneth Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
description	Background: Papulonecrotic tuberculid (PNT) is said to be a hypersensitivity reaction to M. tuberculosis. Some reports indicate that organisms are demonstrable by polymerase chain reaction (PCR). Methods: We describe 12 patients with PNT over 6 years. We reviewed the histopathologic features, clinical data and follow-up. PCR for M. tuberculosis DNA was done in all cases. Results: There were 7 men and 5 women. The ages ranged from 3-58 years. Upper limbs were commonly involved (8 cases). All patients had multiple papulonodular lesions, 5 showed ulceration and scarring. Mantoux test was strongly positive in all. Seven patients had systemic tuberculosis. On microscopy, necrosis was seen in 11 cases, varying from minimal to extensive. Epithelioid granulomas were common, except for 1 case with palisading and interstitial patterns. The infiltrate showed mostly lymphocytes, while 3 cases showed eosinophils. Vasculitis was seen in 8 cases. Two cases had dermal mucin, one also with interface dermatitis. This patient had concurrent LE. Mycobacterial DNA was detectable by PCR in 3 cases. Seven patients showed improvement/resolution of lesions on treatment. Conclusions: PNT is a rare disease. A positive PCR reiterates the question whether these are “tuberculids”. PNT may be better classified as true cutaneous tuberculosis and patients screened for systemic disease.
format	article
author	Rajalakshmi Tirumalae Inchira K. Yeliur Meryl Antony Geojith George John Kenneth
author_facet	Rajalakshmi Tirumalae Inchira K. Yeliur Meryl Antony Geojith George John Kenneth
author_sort	Rajalakshmi Tirumalae
title	Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
title_short	Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
title_full	Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
title_fullStr	Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
title_full_unstemmed	Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients
title_sort	papulonecrotic tuberculid—clinicopathologic and molecular features of 12 indian patients
publisher	Mattioli1885
publishDate	2014
url	https://doaj.org/article/2d1c360b764f4477b815cadb33a6f0ce
work_keys_str_mv	AT rajalakshmitirumalae papulonecrotictuberculidclinicopathologicandmolecularfeaturesof12indianpatients AT inchirakyeliur papulonecrotictuberculidclinicopathologicandmolecularfeaturesof12indianpatients AT merylantony papulonecrotictuberculidclinicopathologicandmolecularfeaturesof12indianpatients AT geojithgeorge papulonecrotictuberculidclinicopathologicandmolecularfeaturesof12indianpatients AT johnkenneth papulonecrotictuberculidclinicopathologicandmolecularfeaturesof12indianpatients
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Papulonecrotic tuberculid—clinicopathologic and molecular features of 12 Indian patients

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