A 24-year-old woman was evaluated 12 weeks after normal vaginal delivery for recurrent painful nodular skin rash present on and off for the last 2 years. Two days before presentation, red, painful, and nonpruritic rash had appeared on her upper and lower extremities. The patient denied fever, weight loss, night sweat, cough, shortness of breath, or any other symptoms. Upon physical examination, multiple tender violaceous nodules with no fluctuation, ulceration, or drainage were seen (Figure 1). During the patient’s last pregnancy she was noted to have latent tuberculosis infection with a positive QuantiFERON test results and negative findings at chest radiography. She had immigrated from Vietnam to the United States 6 years before her current presentation, and she denied any previous testing or treatment for tuberculosis.
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