PMC9673929_01
(A) Physical examination reveals an indurated erythematous plaque on the middle of the right thumb, and a few clear liquids can be observed when pressed. (B) The skin lesion is healed after an anti-tuberculous therapy.
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Physical examination revealed an indurated erythematous plaque at the middle of the thumb, a few clear liquids can be observed when pressed (Figure 1A), and tender multiple right axillary LN. After 4 weeks of treatment, the finger lesion had disappeared (Figure 1B).
(A)CT scan of the chest shows multiple enlarged lymph nodes in the right axilla and right pleural effusion (white arrows). (B) MRI of the right hand shows an abnormal signal on the palmar side of the first proximal phalangeal bone of the right hand. T2W1 shows high signal intensity. The lesion extends along the tendon sheath of the flexor tendon into the carpal canal.
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A chest computed tomography (CT) scan showed multiple enlarged LN in the right axilla and right pleural effusion (white arrows) (Figure 2A). Magnetic resonance imaging (MRI) of the right hand (conducted 50 days after the needlestick) showed tenosynovitis involvement of the entire flexor tendon of the thumb (Figure 2B).