CLINICAL PRESENTATION: The patient was a 56-year-old woman with a history of hypertension and hyperlipidemia from one year ago. About two years ago, papule and PUSTULAR LESIONS emerged in the extensor area of both elbows,the LESIONS were accompanied by purulent discharge and brief itching, gradually turning into erythematous perforated indurated plaques and nodules within a month. These skin LESIONS then spread to the extensor surfaces of the knees, fingertips (painful LESIONS), scalp, and neck (Figures 1-3). The skin LESIONS appeared periodically and persisted for one month, with a two-three-month interval between each period. The patient complained of dyspnea on exertion but had no symptoms of cough, hemoptysis, weight loss, fever and chills, and night sweats. A PPD skin test was performed and returned positive,tuberculosis was also reported on a CT scan of the lungs. Furthermore, evidence in favor of tuberculosis was reported in a sample of the right axillary lymph nodes. After treatment, the LESIONS healed entirely, and only the elbow and knee scars remained...