PMC9325874_01
Red erythema and plaques on the right cheek before treatment.
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Physical examination of her right cheek revealed erythema, papules, and slight desquamation (Figure 1).
Skin biopsy histopathology showed mild epidermal hyperplasia, with several epithelial cell masses of different sizes in the superficial and deep dermis. Lymphocytes were infiltrated around, and the boundary was clear (hematoxylin and eosin stain, 40X (A) and 100X (B) magnifications).
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Caseous necrosis was not observed (Figure 2A and B).
Round milky yellow colonies on Lowenstein-Jensen medium.
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The positive colonies that grew on the Lowenstein-Jensen medium tissue sample inoculated after 35 days at 37 C were identified as MTB by PCR and DNA sequencing and acid-fast bacilli staining (Figure 3).
Positive white colonies grew on the SDA medium.
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The positive colonies that grew on the medium after ten days were identified as Candida albicans (Figure 4).
Dark red erythema on right cheek after treatment without scar.
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Itraconazole 0.2 g bid was administered for seven days, and rifampicin 0.45 g qd, isoniazid tablet 0.3 g qd, and ethambutol hydrochloride 0.25 g tid were administered for five months (Figure 5).