A rare case of scrofuloderma along with lupus vulgaris

Cutaneous forms of tuberculosis are rare, comprising about 1-1.5% of all cases, and show a wide range of clinical manifestations. Here we present a case of a patient with left cervical ulcerated lymphadenopathy associated with a violaceous plaque in the area of the manubrium of sternum. We performed a biopsy of the plaque for histopathology, a polymerase chain reaction (PCR) to test for mycobacteria and a smear of the ulcerated lymph node. Histopathology results showed a dermal infiltrate consisting of epithelioid granulomas without necrosis, PCR was negative, and the culture was positive for M. tuberculosis . We made the diagnosis of scrofuloderma associated with lupus vulgaris. The patient was treated with an anti-tuberculous therapy with clinical regression of the lesions. Our case emphasizes the importance of recognizing that tuberculosis can occur as a primary cutaneous pathology, with a challenging diagnosis that requires the correlation of clinical findings with diagnostic testing. Transient acantholytic dermatosis (TAD) is a relatively common entity that has been also noted to occur in patients with cancer. Herein, we describe a case of transient acantholytic dermatosis occurring in a patient with a history of prostate cancer status post radiation, now being treated with combination therapy with pembrolizumab and carboplatin-pemetrexed for advanced lung adenocarcinoma. Our case emphasizes the importance of being cognizant of TAD and its associations, particularly in cancer patients.