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January 1988

Subcutaneous Nodules in a Man Diagnosed as Having Tuberculosis

Author Affiliations

Baylor College of Medicine, Houston

Arch Dermatol. 1988;124(1):121-122. doi:10.1001/archderm.1988.01670010085027

REPORT OF A CASE  A 27-year-old man was admitted with a two-month history of multiple tender, raised, erythematous, subcutaneous nodules distributed over his arms, legs, and trunk. Five months prior to admission, the patient had presented with symptoms of nonproductive cough, low-grade fever, night sweats, anorexia, and weight loss. A chest roentgenogram at that time revealed a reticulonodular infiltrate in the right upper lobe, and he was found to have a purified protein derivative (PPD) positive at 20 mm. He was treated with rifampin, isoniazid, and pyrazinamide for the presumptive diagnosis of pulmonary tuberculosis. Three sputum cultures for acid-fast bacilli, however, were negative. He initially felt better, but developed similar symptoms in the ensuing months. He noted a 22-lb weight loss during this time period. His medical history was otherwise unremarkable.The subcutaneous nodules reportedly began as small "pimples" that gradually enlarged and became fluctuant and mildly warm