case_images: PMC7757284_01
case_images: A, B) extensive verrucous plaque covered in dark dense crust over the gluteus, thigh and scrotum with an irregular border; fissures were seen over the dense crust and multiple ulcers
case_images: PAMJ-37-131-g001.jpg
case_images: PMC7757284_01_PAMJ-37-131-g001.jpg
case_images: F1
case_images: Fissures and multiple ulcers were seen over the dense crust with foul-smelling seropurulent discharge (Figure 1).
case_images: epithelioid granulomatous inflammation surrounding the caseous necrosis (arrow) along with several Langerhans cells in the dermis and many lymphocytic infiltrates
case_images: PAMJ-37-131-g002.jpg
case_images: PMC7757284_01_PAMJ-37-131-g002.jpg
case_images: F2
case_images: Skin biopsy of the lesion was performed and histopathology analysis showed marked pseudoepitheliomatous hyperplasia of epidermis, epithelioid granulomatous inflammation surrounding the caseous necrosis along with several Langerhans cells in the dermis and many lymphocytic infiltrates (Figure 2).
case_images: A) at two months follow-up, the skin lesions showed significant improvement; B) the lesions were completely resolved after four months of therapy leaving atrophic scars
case_images: PAMJ-37-131-g003.jpg
case_images: PMC7757284_01_PAMJ-37-131-g003.jpg
case_images: F3
case_images: A multidisciplinary approach by referring to the Pulmonology department was carried out and anti-tuberculosis treatment (ATT) regimen 1 consisted of two-month intensive phase (Rifampicin 450mg, Isoniazid 225mg, Pyrazinamide 1200mg, Ethambutol 825mg daily) followed by four-month continuation phase (Rifampicin 450mg, Isoniazid 450mg three times a week) was given. At two-month follow-up, the skin lesions showed significant improvement and the lesions were completely resolved after four months of therapy leaving atrophic scars (Figure 3).