PMC8742584_01
Macroscopic observation of the lesions. Periumbilical region (a), left arm (b).
acmi-3-0280-g001.jpg
PMC8742584_01_acmi-3-0280-g001.jpg
F1
During the clinical examination, painful, erythematous-violet subcutaneous nodules in the periumbilical region and left arm were found (Fig. 1).
Excision biopsy of the skin lesions.
acmi-3-0280-g002.jpg
PMC8742584_01_acmi-3-0280-g002.jpg
F2
After the excision biopsy of the skin lesions (Fig. 2), samples were sent to the laboratory.
Ziehl-Neelsen staining of the thioglycollate enrichment medium. We observe BAAR.
acmi-3-0280-g003.jpg
PMC8742584_01_acmi-3-0280-g003.jpg
F3
The Ziehl-Neelsen staining was negative for BAAR, and the PAS-Hematoxylin staining negative for fungal elements, giving the diagnosis of granulomatous hypodermitis with probable infectious aetiology (Fig. 3).
Mycobacterium abscessus

 colonies on blood agar 5 days after incubation.
acmi-3-0280-g004.jpg
PMC8742584_01_acmi-3-0280-g004.jpg
F4