Erythema Nodosum Caused by Mycobacterium tuberculosis in HTLV-1 Infected Patients

Abstract

HTLV-1 infection seems to increase the susceptibility to tuberculosis (TB), however in that HTLV-1 and TB co infected patients, skin lesions due to Mycobacterium tuberculosis have rarely been described. Erythema nodosum is a skin disorder clinically associated a subcutaneous nodules induced by various pathogens, drugs and other miscellaneous conditions. Here, were described two cases of HTLV-1 patients with recurrent Erythema nodosum associated with M. tuberculosis. One of the patients did not present any TB pulmonary symptoms or X-ray abnormalities. Skin culture, sputum and acid fast bacilli staining for mycobacterium were all negatives. The tuberculin skin test was strongly positives and the infection with M. tuberculosis was detected by qPCR at skin lesions. Both patients were treated for TB and the Erythema nodosum clinically ameliorated. In conclusion, these data reveals that Erythema nodosum in HTLV infected patients might be a clinical manifestation associated to cutaneous tuberculosis.