PMC10298620_01
(A-F) Erythematous nodules over chin, nose, bilateral arms, and thigh along with plaque-like lesion over the sole
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A 15-year-old female presented to our Dermatology outpatient department with multiple nodules over bilateral arms, face, left thigh, and bilateral soles for 1 year [Figure 1A-F] with no family history or contact history.
(A-C) Scattered foamy macrophages and neutrophils with extracellular and intracellular negative images of bacilli (Giemsa and PAP x10, x40); (D) Bright red positive bacilli (ZN, x100)
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Cytosmears showed many scattered foamy macrophages, lymphocytes, and neutrophils [Figure 2A-C]. ZN stain was positive for the negative images that were seen on the Giemsa stain [Figure 2D].
(A-C) Nodular dome-shaped lesion on biopsy with grenz zone. Histopathology showing dense perivascular and perifollicular lymphomononuclear cells infiltrate along with foamy histiocytes (H and E x10, x20, x40); (D) Positive Fite-Faraco stain for lepra bacilli (Fite, x100)
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The underlying dermis showed dense perivascular, perifollicular, and perineural lymphomononuclear cell infiltrate along with foamy histiocytes and necrosis [Figure 3A-C]. Fite-Faraco staining for lepra bacilli showed a bacillary index of 6+ [Figure 3D].