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Arch Pediatr Adolesc Med. 2007;161(3):304.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Denouement and Discussion: Severe Skin Ulceration After Tuberculin Skin Test

The patient's primary diagnosis was lymphadenitis caused by Mycobacterium tuberculosis. The skin necrosis was related to tuberculin skin testing.

A bulla (22 mm in diameter) developed 4 days after a PPD injection (Figure, A and B). The erythema extended, covering almost all the volar forearm, from the elbow down to the wrist (black mark in Figure, A). The full thickness of the skin covering the bulla dislodged 2 days later, with granulation tissue and some yellowish eschar left (Figure, C on day 7 postinjection). Vancomycin hydrochloride was administered empirically for 2 days to treat presumed cellulitis. Cultures of blood and swab tests from the base of the bulla were negative for microorganisms. A biopsy specimen of the right cervical lesions revealed granulomatous inflammation, caseous necrosis, multinuclear giant cells, and acid-fast bacilli suggestive of mycobacterial infection. The patient was treated with isoniazid, rifampin, ethambutol hydrochloride, and . . . [Full Text of this Article]

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