case_images: PMC10962352_01
case_images: (a) Erythematous infiltrated plaques, sarcoid-like, with telangiectasias on the right malar region, nose, forehead, and right upper eyelid. (b) Improvement of skin lesions (day 30 of treatment). (c) Gingival ulcerated lesion with hemorrhagic dots (moriform stomatitis).
case_images: 1678-9849-rsbmt-57-e00804-2024-gf1.jpg
case_images: PMC10962352_01_1678-9849-rsbmt-57-e00804-2024-gf1.jpg
case_images: f1
case_images: Physical examination revealed sarcoid-like infiltrative erythematous plaques with telangiectasias in the right malar region, nose, forehead, and right upper eyelid, as well as an ulcerated gingival lesion with hemorrhagic dots (Figure 1). She is still undergoing oral treatment and imaging shows progressive regression of the skin lesions (Figures 1B and 3D).
case_images: (a) Anatomopathological analysis: granulomatous dermatitis with non-sporulating fungi showing thick walls surrounded by multinucleated giant cells of the Langhans type (HE, 400x). (b) Anatomopathological analysis: Grocott-Gomori staining demonstrating non-sporulating fungi (Grocott-Gomori, 400x).
case_images: 1678-9849-rsbmt-57-e00804-2024-gf2.jpg
case_images: PMC10962352_01_1678-9849-rsbmt-57-e00804-2024-gf2.jpg
case_images: f2
case_images: A new skin biopsy revealed granulomatous and suppurative dermatitis and non-sporulating fungi with thick walls, which were stained black by Grocott-Gomori, and were surrounded by Langhans giant cells (Figure 2).
case_images: Abdominal Computed Tomography: (a) Diffuse adrenal enlargement (yellow arrow); (b) Significant parietal thickening of the distal ileum (red bracket) and multiple enlarged lymph nodes in mesenteric chains (red dots). Brain magnetic resonance imaging (MRI): (c) Peripheral oval focal lesion in the left cerebellar hemisphere, with ring enhancement by gadolinium, associated with adjacent leptomeningeal impregnation; (d) Regression of the oval focal lesion in the left cerebellar hemisphere (day 40 of treatment).
case_images: 1678-9849-rsbmt-57-e00804-2024-gf3.jpg
case_images: PMC10962352_01_1678-9849-rsbmt-57-e00804-2024-gf3.jpg
case_images: f3
case_images: Brain magnetic resonance imaging (MRI) revealed a peripheral oval focal lesion in the left cerebellar hemisphere (Figure 3). She is still undergoing oral treatment and imaging shows progressive regression of the skin lesions (Figures 1B and 3D).