PMC5297268_01
Deep ulcer over the right sole (hyperkeratotic and macerated margin with clean floor)
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F1
On local cutaneous examination, a deep seated ulcer of 6 cm x 4 cm x 2 cm size was seen over the right sole, whose floor was clean (because of previous antiseptic cleaning) and the margin was hyperkeratotic and macerated [Figure 1].
Multiple, coalescing, firm, pink-coloured verrucous nodules of varying sizes in a "Streusel-bread"-like appearance
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F2
Along the lateral border and on the lateral malleolus of right foot, multiple, coalescing, firm, pink-coloured verrucous nodules of varying sizes (largest measuring 3 cm x 2.5 cm) in a "Streusel-bread"-like appearance were present [Figure 2].
Vertically oriented proliferation of epidermis centred around acrosyringium extending into the reticular dermis (H and E, x20)
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F3
Thin, anastomosing, vertical strand comprising acrosyringeal structures including ductal cuboidal epithelial cells (arrow) and lumina embedded in fibrovascular stroma (H and E, x40)
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F4
Well-formed eccrine ducts with double-layered cuboidal cells (H and E, x40)
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F5