title: A case of multifocal lupus vulgaris that preceded pulmonary tuberculosis in an immune compromised patient.
abstract: We describe the rare case of a Japanese male with multifocal lupus vulgaris that preceded asymptomatic pulmonary tuberculosis and adult T-cell leukemia/lymphoma (ATL). He visited our hospital with multiple reddish plaques and erythema of 4-12 months duration. A skin biopsy revealed non-caseating epithelioid granulomas. Mycobacterium tuberculosis was detected by polymerase chain reaction (PCR)-hybridization from a skin biopsy specimen and was also isolated from a culture of the skin biopsy sample. The result of chest roentogenography was compatible with pulmonary tuberculosis. In addition, the diagnosis of ATL was based upon the presence of atypical lymphocytes with convoluted nuclei in his peripheral blood and a positive anti-ATL antibody reaction. Cases of cutaneous tuberculosis presenting with unusual clinical features may be on the increase, accompanying the spread of tuberculosis in immunosuppressed patients, including those with ATL and acquired immunodeficiency syndrome (AIDS).
authors.affiliation: Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hamada
authors.forename: Kazunori
authors.initials: K
authors.lastname: Urabe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Moroi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Koga
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeishi
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujita
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Masutaka
authors.initials: M
authors.lastname: Furue
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D015458:Leukemia, T-Cell / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008177:Lupus Vulgaris / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000473:pathology