PMC4325702_01
(A) Erythematous swelling of the right thumb with erosion and maceration. (B) Epidermal necrosis, neutrophilic infiltration in the mid dermis (hematoxylin-eosin (HE), original magnification x40). (C) Caseous necrosis surrounded by histiocytes (HE x400). (D) Ziehl-Neelsen staining demonstrated acid-fast bacilli (x400).
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Clinical examination revealed erythematous swelling on the right thumb with erosion and maceration (Fig. 1A). Histopathologic examination revealed caseous necrosis surrounded by histiocytes and a positive result was obtained for acid-fast bacilli by Ziehl-Neelsen staining (Fig. 1B-D).