Papulonecrotic Tuberculids Treatment & Management
- Author: Manuel Valdebran, MD; Chief Editor: William D James, MD more...
Treatment is directed at eradicating the underlying mycobacterial infection. Tuberculosis treatment guidelines may vary from region to region and from different authorities (ie, the World Health Organization [WHO] and the Centers for Disease Control and Prevention [CDC]). Currently, for patients with active tuberculosis, a 4-drug therapy with rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) is recommended to avoid the development of resistance. Papulonecrotic tuberculids respond promptly to appropriate antituberculosis therapy. New lesions cease forming within days to weeks after therapy is initiated, and existing lesions heal rapidly, usually within several months. A minimum of 6 months of anti-tuberculosis therapy is recommended. Recurrences rarely occur after appropriate therapy.
Also see the Medscape Drugs and Diseases articles Tuberculosis and Tuberculosis Organism-Specific Therapy, as well as the World Health Organization guidelines, Recommendations for Investigating Contacts of Persons with Infectious Tuberculosis in Low- and Middle-Income Countries.
Darier MJ. Des "tuberculides" cutanees. Ann Dermatol Syph. 1896. 7:1431-36.
Tirumalae R, Yeliur IK, Antony M, George G, Kenneth J. Papulonecrotic tuberculid-clinicopathologic and molecular features of 12 Indian patients. Dermatol Pract Concept. 2014 Apr. 4(2):17-22. [Medline]. [Full Text].
Sloan JB, Medenica M. Papulonecrotic tuberculid in a 9-year-old American girl: case report and review of the literature. Pediatr Dermatol. 1990 Sep. 7(3):191-5. [Medline].
Iden DL, Rogers RS 3rd, Schroeter AL. Papulonecrotic tuberculid secondary to Mycobacterium bovis. Arch Dermatol. 1978 Apr. 114(4):564-6. [Medline].
Freiman A, Ting P, Miller M, Greenaway C. Papulonecrotic tuberculid: a rare form of cutaneous tuberculosis. Cutis. 2005 Jun. 75(6):341-6. [Medline].
Morrison JG, Fourie ED. The papulonecrotic tuberculide. From Arthus reaction to lupus vulgaris. Br J Dermatol. 1974 Sep. 91(3):263-70. [Medline].
Senol M, Ozcan A, Aydin A, Karincaoglu Y, Sasmaz S, Sener S. Disseminated lupus vulgaris and papulonecrotic tuberculid: case report. Pediatr Dermatol. 2000 Mar-Apr. 17(2):133-5. [Medline].
Milligan A, Chen K, Graham-Brown RA. Two tuberculides in one patient--a case report of papulonecrotic tuberculide and erythema induratum occurring together. Clin Exp Dermatol. 1990 Jan. 15(1):21-3. [Medline].
Thappa DM, Karthikeyan K, Jayanthi S. Tuberculid in a child: transformation from papulonecrotic to lichen scrofulosorum. Pediatr Dermatol. 2003 Jan-Feb. 20(1):91-3. [Medline].
Asiniwasis R, Dutil MT, Walsh S. Molluscum-Like Papules as a Presentation of Early Papulonecrotic Tuberculid in Association with Nodular Tuberculid in a Male with Asymptomatic Active Pulmonary Tuberculosis. J Cutan Med Surg. 2014 Aug 1. 18(0):1-4. [Medline].
Chalermdamrichai P, Puavilai S, Jerasutus S, Boonsarngsuk V, Kiattboonsri S, Suwatanapongched T. Sarcoidosis presenting as papulonecrotic tuberculid-like lesions: report of a case. J Med Assoc Thai. 2004 Jul. 87(7):839-44. [Medline].
Sim JH, Whang KU. Application of the QuantiFERON®-TB Gold test in erythema induratum. J Dermatolog Treat. 2014 Jun. 25(3):260-3. [Medline].
[Guideline] World Health Organization. Recommendations for Investigating Contacts of Persons with Infectious Tuberculosis in Low- and Middle-Income Countries. Available at http://apps.who.int/iris/bitstream/10665/77741/1/9789241504492_eng.pdf. Accessed: October 23, 2014.