患者女,20岁。四肢丘疹、丘脓疱疹、溃疡5年,颈部结节、溃疡、瘢痕6个月。相关实验室检查包括结核PPD试验(强阳性),γ-干扰素释放试验(阳性),结核荧光定量PCR(可疑阳性)。颈部皮损组织病理示:表皮轻度肥厚,真皮内大片干酪样坏死,可见散在上皮样肉芽肿及较多淋巴细胞、少量浆细胞浸润。小腿皮损组织病理示:表皮呈银屑病样增生,真皮及皮下脂肪浅层小血管周围较多淋巴细胞,少量嗜酸性粒细胞浸润。诊断:丘疹坏死性结核疹并瘰疬性皮肤结核。 Female patient, 20 years old. Limbs limbs, cough pus herpes, ulcers for 5 years, neck nodules, ulcers, scars 6 months. Related laboratory tests include tuberculosis PPD test (strong positive), γ-interferon release test (positive), tuberculosis fluorescence quantitative PCR (suspicious positive). Histopathology of cervical lesions showed mild epidermis, large caseous necrosis in the dermis, scattered epithelioid granulomas and more lymphocytes, a small amount of plasma cells infiltration. Histopathological lesions showed callus lesions: Psoriasis-like hyperplasia of the epidermis, dermal and subepithelial fat small blood vessels around the more lymphocytes, a small amount of eosinophil infiltration. Diagnosis: Papular necrotizing tuberculosis and tuberculous skin tuberculosis.