PMC6180358_01
Overlying the patient's left fifth digit, an erythematous, ulcerated plaque is noted.
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Several months later, the patient returned with a significant change: ulceration had occurred within the centre of the plaque (Figure 1).
To the patient's left hand, wrist, and arm, scattered papulonodules are noted with a sporotrichoid pattern.
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In addition, approximately half a dozen tender, subcutaneous nodules were noted, extending from his left fifth digit superiorly to his elbow in a sporotrichoid pattern (Figure 2).
Within the dermis of the biopsy specimen, a granulomatous infiltrate is seen, compatible with the diagnosis of fish-tank granuloma.
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Ultimately, the biopsy sent for histopathology revealed a dermal granulomatous infiltrate supporting this diagnosis (Figure 3).