PMC9720230_01
Solitary, violaceous 1.1 x 0.9 cm plaque with violaceous perimeter and central black eschar on the left lateral shin.
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fig1
Thin dusky papule with violaceous rim and fine scale on the right elbow.
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fig2
Thin scaly erythematous papule with violaceous rim on the right dorsal hand.
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fig3
A 3 mm punch biopsy, left lateral shin. Hematoxylin and eosin (A) reveals a vasculopathic reaction with hemorrhage, and purpura. Periodic acid-Schiff stain (B) and Grocott's Methenamine Silver stain (C) reveal multifocal clusters of hyphal septated forms with variable, acute-angle branches and spores.
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fig4
Grocott's methenamine silver (GMS) revealed easily identifiable clusters of hyphal and spore forms, the former of which exhibited septations with acute-angle branching (Fig 4). Gram stain was negative for bacterial superinfection.