LAUSR

A previously healthy 9-year-old girl presented to our emergency department with a painful skin rash over both legs, which had started 4 days earlier. The patient did not report any other symptoms like fever, fatigue, anorexia, weight loss or cough. She did not take any medications. Physical examination revealed painful erythematous nodules in both shins. The lesions were poorly demarcated, warm, tender, with 2–4 cm in diameter (Figs 1,2). There were no other skin or mucous membrane lesions. These lesions were compatible with erythema nodosum (EN). The patient underwent investigation for a possible underlying systemic disease. Laboratory tests and chest radiography were normal. Interferongamma release assay and tuberculin test were both positive. Mycobacterium tuberculosis was not detected. Therefore, EN likely due to tuberculosis (TB) infection was diagnosed and she received adequate triple antituberculosis therapy and had significant improvement. Family members of the patient were screened for exposure to TB.