<prompt> Mikulicz cells and Russell bodies are seen inRhinoscleromaRhinophymaRat bite feverLyme disease  <response>: Rhinoscleroma Chronic granulomatous infection of nose and upper respiratory tract Affects adults, mainly in tropical locations Transmitted by inhalation of Klebsiella rhinoscleromatis aw cellular immune defects: inability of macrophages to kill phagocytosed bacteria - Mikulicz cells large, vacuolated histiocytes containing bacteria Three clinical phases: Catarrhal phase rhinitis, obstruction from soft tissue edema Granulomatousinfiltrative phase granulomatous nodules in noseU, epistaxis, dysphonia, anesthesia of soft palate, and Hebra nose Sclerotic phase extensive scarring requires tracheotomy and nasal reconstruction Histology:- Dense pan-dermal infiltrate of Mikulicz cells containing bacteria seen w Wahin-Starry, Giemsa and Russell bodies Treatment:- Tetracyclinetreatment of choice for 6 months along with surgical correction of airway; ciprofloxacin is second line. Above picture shows RUSSELL Bodies Ref:- Review of Dermatology by Alikhan; pg num:-299 