Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 17-1982. Fever and subcutaneous masses in an elderly man

Papular tuberculids post-BCG vaccination

A 3-month-old child with a grossly symmetrical monomorphic papular acral-located skin eruption, a voluminous lymphadenopathy post-BCG vaccination, and hepatomegaly was seen. The diagnoses of Gianotti-Crosti's syndrome and generalized tuberculous infection have been discarded. The appearance of these lesions 48 hours after a tuberculin patch test, their tuberculoid structure, and the absence of any systemic involvement favored the diagnosis of papular tuberculids, a rarely reported complication of BCG vaccination.

Panniculitis associated with histoplasmosis and alpha 1-antitrypsin deficiency

A patient with mediastinal histoplasmosis, alpha 1-antitrypsin deficiency, and panniculitis is presented. The patient showed dramatic response to treatment with ketoconazole. The associations of panniculitis with histoplasmosis and alpha 1-antitrypsin deficiency are discussed.