Cutaneous Nontuberculous Mycobacterial Infection Misdiagnosed as Rheumatoid Nodule in a Patient with Rheumatoid Arthritis
- Author:
Nam Gyoung HA
1
;
Dae-Lyong HA
;
Jun Young KIM
;
Yong Hyung JANG
;
Weon Ju LEE
;
Seok Jong LEE
;
Kyung Duck PARK
Author Information
1. Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
- Publication Type:Case Report
- From:Korean Journal of Dermatology
2024;62(4):242-246
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Owing to advances in diagnostics and the increase in invasive procedures, and immunocompromised patients, cutaneous nontuberculous mycobacteria (NTM) infection is rising. NTM should be suspected in patients with persistent skin lesions refractory to treatment with a history of immunosuppression or skin injury. A 59-year-old woman presented with a 4-week history of multiple erythematous tender nodules on left arm. A year prior, multiple nodules appeared on left hand dorsum, followed by recurrent suppurative nodules in left arm. She has been taking methotrexate and leflunomide for 7 years due to rheumatoid arthritis (RA). Skin biopsy revealed granulomatous inflammation, and NTM polymerase chain reaction test was positive. Furthermore, she had cut her left finger with a knife 14 months ago. Based on these findings, cutaneous NTM infection was diagnosed. Herein, we report a case of cutaneous NTM infection in an immunosuppressed patient with RA, emphasizing differentiating subcutaneous nodules from rheumatoid nodules in RA.
