PMC4926288_01
Between 2008 and 2012 the patient underwent several surgical amputations of fingers: distal phalanges of second, third and fourth fingers of right hand
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Fig1
Due to pain and severe functional limitation, at this site, between 2008 and 2012 the patient underwent several surgical amputations of fingers: the distal phalange of the third finger of his left foot, the distal phalanges of second, third and fourth fingers of his right hand and the distal phalange of first finger of his right foot (Fig. 1).
Skin's section: a chronic granulomatous process, with epitelioid histiocytes, rare multinuclear giant cells sorrounded by lymphocytes without central necrosis
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Fig2
In all these cases, pathological examination described a chronic granulomatous flogistic process, that involved entirely all the anatomical structures (from bone to skin), with epitelioid histiocytes, multinuclear giant cells surrounded by lymphocytes, and in some granulomas central necrosis (Fig. 2).
The lesions tended to recur at proximal metacarpophalangeal joints of fingers amputated of distal parts
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Fig3
The lesions tended to recur in other fingers of his hands and feet, and at proximal metacarpophalangeal joints of fingers amputated of distal parts; in addition, for several years a rubbery non erythematosus nor painful plaque was present, without modifications in the left perimalleolar region (Fig. 3).