PMC4372314_01
Erythematous-brown plaque, hardened and rough, with some reddish-honey colored crusts on the dorsum of the fifth right finger, before treatment.
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Fig1
The lesion did not affect the nail (Figure 1).
Skin biopsy - Histopathology. (a) Pseudocarcinomatous epithelial hyperplasia with amorphous material in the follicular epithelium, which is surrounded by intense infiltrates of lichenoid pattern (HE, original magnification 40x). (b) Chronic granulomatous inflammatory reaction of tuberculoid pattern with focus of fibrinoid necrosis and absence of acid-fast bacilli (Fite-Faraco, original magnification 200x).
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Fig2
Mycobacterium marinum
culture on Lowenstein-Jensen medium, after 12 days of incubation at 26 C (78.800 F).
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Fig3
Evolution during and after treatment. (a) Dorsum of the fifth right finger, one month after the beginning of treatment. (b) Dorsum of the right finger, three months after initiation of treatment.
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Fig4
After being diagnosed, the patient was treated with clarithromycin (1 g/day) for three months, resulting in regression of the lesion (Figure 4).