PMC7471781_01
(a) A large well demarcated annular plaque of 10 by 7.5 cm over the right upper back, which extended to the axilla. (b) Multiple monomorphic papules of 0.5 to 1 cm in size over the right upper limb (bold arrows).
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F1
On physical examination, there was a large well demarcated annular plaque of 10 by 7.5 cm over the right upper back, which extended to the axilla (Fig. 1a). There were also multiple monomorphic papules of 0.5 to 1 cm in size over the upper limbs (Fig. 1b), face, proximal aspect of lower limbs and the gluteal region.
(a) Skin punch biopsy from the right upper back plaque (H&E). (b) There is a diffuse superficial dermal infiltrate of epithelioid histiocytes without well-formed granulomas. Foamy cytoplasm was seen in only a portion of the histiocytes (H&E). (c) Fite-positive bacilli were observed within the inflammatory infiltrate (Fite stain).
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F2
Foamy cytoplasm was seen in only a portion of the histiocytes and was subtle (Fig. 2a, b). Fite-positive bacilli were identified within the inflammatory infiltrate (Fig. 2c).
PMC7471781_02