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  Vol. 141 No. 7, July 2005 TABLE OF CONTENTS
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Chronic Infiltrates and Persisting Ulcerations on the Arms and Legs—Diagnosis

Arch Dermatol. 2005;141:897-902.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Mycobacterium haemophilum infection.

MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE

Histologic examination of the biopsy specimen revealed a dense, diffuse infiltrate in the dermis and subcutaneous tissue consisting almost exclusively of granulocytes. Because there was concern regarding an infectious process, a Ziehl-Neelsen stain was performed, which showed numerous acid-fast bacilli (Figure 4). Culture of tissue on Jensen-Löwenstein agar did not yield mycobacteria, but acid-fast bacilli were found in the sputum sample as well as in the smear from an ulcerative lesion on the hand.


 
Figure appears in full text version.
Figure 4.


On further questioning, the patient admitted that he had deliberately increased the recommended dosage of prednisone on many occasions (up to 150 mg/d) because of the psychotropic effects. After the histologic diagnosis of mycobacterial infection was made, his therapy was changed to a combination of isoniazid, ethambutol hydrochloride, and rifampin. During the following days, he also developed pneumonia with Aspergillus fumigatus, and despite immediate transfer to an intensive care unit, he . . . [Full Text of this Article]

DISCUSSION


RELATED ARTICLE

Chronic Infiltrates and Persisting Ulcerations on the Arms and Legs—Quiz Case
Esther von Stebut, Katharina Wiest, and Wolfgang Braeuninger
Arch Dermatol. 2005;141(7):897-902.
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