PMC9215351_01
Reddish hypertrophic ulcerative plaque on the left neck and verrucous proliferating nodules of the left ear of the patient before treatment.
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Physical examination showed a reddish nodular plaque with superficial erosions, tough textures, well-defined borders on his neck in a size of 18 x 10 cm and verrucous proliferating nodules behind his left ear with no abnormalities on neurological examination (Figure 1).
Hematoxylin and eosin staining of skin biopsy specimen showed infectious granuloma (A) with necrosis and infiltrates of lymphocytes, epithelioid cells and Langhans giant cells (B) (original magnification: upper panel x12.5, lower panel: x100).
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Histopathological examination of the lesion on the neck showed necrosis and epithelioid-cell granuloma (Figure 2A) in the dermis, which infiltrates lymphocytes, epithelioid cells and Langhans giant cells (Figure 2B) and negative findings of periodic acid-Schiff, silver and Ziehl-Neelsen stains.
Clinical photographs after six months' antituberculosis treatment: the lesions were almost completely cleared leaving scars and hyperpigmentation after 6 months.
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After six months of follow-up, the lesions were almost completely cleared, leaving residual scar and hyperpigmentation (Figure 3) and the enlarged lymph nodes were smaller than before on CT scan with no adverse effects during treatment.