PMC5587931_01
Clinical photos.
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fig1
A 54-year-old female, with a history of systemic lupus erythematosus on mycophenolate mofetil (3 g daily), prednisone (10 mg daily), and cyclosporine (50 mg twice a day), presented with a 4-month duration of unilateral painful well-circumscribed erythematous to violaceous subcutaneous nodules extending from her 2nd finger web space to her dorsal wrist and forearm in a sporotrichoid-like pattern (Figure 1(a)). Improvement of her skin lesions was evident on follow-up within three months (Figure 1(b)).
Pathologic findings from a right wrist skin nodule: suppurative granulomatous dermatitis in deep dermis (a & b) and numerous acid-fast bacilli highlighted by Fite's acid-fast stain (c).
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fig2
Dorsal wrist nodule biopsy revealed suppurative granulomatous inflammation (Figures 2(a) and 2(b)). Both acid-fast bacilli (AFB) and Fite's acid-fast stains (Figure 2(c)) showed bacilli in the dermis, consistent with a mycobacterial infection.