CUTANEOS TUBERCULOSIS MIMICKING DISEASE ACTIVITY IN A PATIENT WITH OVERLAP SYNDROME

The rheumatologic cutaneous manifestations closely resemble skin infections with indolent evolution. However, the diagnostic differentiation is important for a appropriate treatment. Erythema nodosum is an injury that is inserted in this context, can be associated with disease activity, but also tuberculosis. In the usual screening for the initiation of immunosuppression, a mandatory test is the tuberculin test, mainly when considering the Brazilian epidemiology. However, some patients may not be positive for this test even in the presence of tuberculosis infection. In this case, the differentiation of the two conditions becomes even more difficult. In the present report, we have a patient with cutaneous tuberculosis, who presented negative tuberculin test in the rituximab screening, worsening the lesion on the introduction of this medication.