case_images: PMC5350300_01
case_images: Plaque with warty surface on forehead.
case_images: CRIDM2017-7285169.001.jpg
case_images: PMC5350300_01_CRIDM2017-7285169.001.jpg
case_images: fig1
case_images: Lesion started as a small papule after 3 months following a roadside fall 2 years back, gradually increased in size, and spread in an annular fashion to form a plaque with warty surface [Figure 1], which started showing ulceration in last 3 months.
case_images: (a) Pseudoepitheliomatous hyperplasia with hyperkeratosis and acanthosis [H and E (40x)]. (b) Pseudoepitheliomatous hyperplasia with hyperkeratosis and acanthosis [H and E (400x)]. (c) Dense inflammatory infiltrates with epithelioid cells and giant cells in the dermis [H and E (400x)]. (d) Ziehl-Neelsen Staining showing scant AFB [ZN Staining (1000x)].
case_images: CRIDM2017-7285169.002.jpg
case_images: PMC5350300_01_CRIDM2017-7285169.002.jpg
case_images: fig2
case_images: A punch biopsy from the lesion showed pseudoepitheliomatous hyperplasia with hyperkeratosis, acanthosis [Figure 2(a), H and E (40x), and Figure 2(b), H and E (400x)], and dense inflammatory infiltrates with epithelioid cells and giant cells in the dermis with few acid fast bacilli (AFB) [Figure 2(c), H and E (400x), and Figure 2(d), ZN Staining (1000x)].
case_images: PMC5350300_02
case_images: Erythematous scaly annular plaque in left axilla extending up to upper inner arm.
case_images: CRIDM2017-7285169.003.jpg
case_images: PMC5350300_02_CRIDM2017-7285169.003.jpg
case_images: fig3
case_images: Biopsy shows well-formed granulomas with epithelioid cells and Langhans giant cells surrounded by chronic inflammatory cells and central necrosis [H and E (400x)].
case_images: CRIDM2017-7285169.004.jpg
case_images: PMC5350300_02_CRIDM2017-7285169.004.jpg
case_images: fig4
case_images: Biopsy revealed well-formed granulomas with epithelioid cells and Langhans giant cells surrounded by chronic inflammatory cells and central necrosis without AFB [Figure 4, H and E (400x)].