PMC7524186_01
Multiple separated hyperkeratotic nodular lesions with erythematic and prominent borders on the patient's face.
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On facial skin examination; lesions appeared as multiple separate hyperkeratotic nodular lesions with erythematic and prominent borders on the face and upper lip with normally appearing skin around the lesions (Figure 1).
Histopathological assessment of lesions revealing skin tissue with multiple granuloma formation in the subepithelial area composed of epithelioid cells, Langhans giant cell, and lymphocyte around them (Magnifications: 10x and 40x).
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The patient's blood tests were normal but skin biopsy revealed skin tissue with multiple granuloma formation in a subepithelial area composed of epithelioid cells, with giant cell and lymphocyte around them (Figure 2).
The Ziehl-Neelsen stained histopathological assessment (Magnifications: 10x and 40x).
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Acid-fast stain of Ziehl-Neelsen (Figure 3) and a purified protein derivative (PPD) skin test due to epidemiology of the tuberculosis helped in the final diagnosis of cutaneous tuberculosis (CTB), caused by acid-fast positive bacteria Mycobacterium tuberculosis infection. At the end of the 8th month (2 months after ending the medical therapy), the patient had no cutaneous and systemic signs or symptoms and the course of treatment ended without any complications (Figure 3).