PMC5311427_01
Right cheek lesions at initial visit.
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fig1
On exam, erythematous, pearly papules were noted on her right medial cheek, right lateral cheek, and left lower cheek (Fig 1).
Acid-fast bacilli within histiocytes and cutaneous nerves. (Fite stain; original magnification: x1000.)
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fig2
Fite stain revealed numerous acid-fast bacilli within the histiocytes and cutaneous nerves (Fig 2).
Facial lesions 2 weeks after triple therapy was initiated.
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fig3
Two weeks after starting triple therapy, the patient's facial lesions worsened, becoming more erythematous (Fig 3).
Multiple foci with acute infiltrates of polymorphs (arrow). (Hematoxylin-eosin stain; original magnification: x1000.)
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fig4
Multiple foci with acute infiltrates of polymorphs were present on her initial biopsy, which is indicative of ENL (Fig 4).