Abstract
Prurigo nodularis (PN) is a chronic skin disorder characterized by intensely pruritic papulonodular lesions that mainly appear on the extensor surfaces of the limbs. The disease is relatively rare and can occur at any age, but it is more commonly reported in middle-aged women. The definition and pathogenesis of PN are somewhat confusing. It is described as being associated with a number of disorders. Numerous infectious agents (bacterial and viral) have been suggested as possible triggers. Although several studies have provided important information linking infectious agents to PN, strong evidence for a direct casual association between such infections and PN is still lacking (Mattila et al., 1996; Neri et al., 1998, 1999; Alfadley et al., 2003; Loffeld & Tan, 2004).
In some cases PN would appear to be the direct result of skin infection, with the infectious organisms identifiable in skin lesions, while in others (e.g. human immunodeficiency virus and viral hepatitis) the lesions are apparently immune-system mediated (Lee & Shumack, 2005; Accioly-Filho et al., 2000). These observations suggest that it is simply a common skin response to a variety of insults. PN is consequently a difficult condition to treat and identifying a treatment strategy can be challenging. To contribute to a better understanding of this skin disorder, we report for what is believed to be the first time a case of PN linked with Mycobacterium tuberculosis complex (MTBC) infection in a patient with pulmonary tuberculosis.