A case of pulmonary tuberculosis preceded by skin tuberculosis

We report a case of pulmonary tuberculosis, which was preceded by skin tuberculosis. 65-year old male was admitted to our hospital complaining of skin eruption which last one year. Skin biopsy proved granuloma with acid-fast bacilli. Mycobacterium tuberculosis was detected by PCR examination using skin biopsy and skin tuberculosis was confirmed. Chest roentogenography demonstrated small nodules with bilateral infiltrates compatible with pulmonary tuberculosis. M. tuberculosis was attained by culture examination using sputa sample. In this case, skin tuberculosis was a first clinical sign to suggest pulmonary tuberculosis. Peripheral blood test showed that he has developed adult T-cell leukemia and this could be an important factor for developing skin tuberculosis. Although skin tuberculosis becomes rare disease, physician should pay attention for this disease as differential diagnosis of lasting eruption.