Pulmonary tuberculosis presenting with cutaneous leukocytoclastic vasculitis

This case report deals with a rare association: tuberculosis and cutaneous leukocytoclastic vasculitis, The patient was a 36-year-old man with no sign ificant past medical problems. He presented with a palpable purpura on both legs, low-grade fever, cough and expectoration, progressive dyspnea due to a massive left pleural effusion and a symmetric swelling on his ankles and wrists. Skin biopsy yielded a histological diagnosis of leukocytoclastic v asculitis and the primary diagnosis was only achieved after performing a pl eural biopsy, which unequivocally showed the presence of Mycobacterium tube rculosis, This case shares many features with the few cases already reporte d in the medical literature. Possible pathogenic mechanisms are reviewed an d discussed in detail.