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Red Annular Plaque on the Dorsum of the Foot—Diagnosis
Arch Dermatol. 2008;144(8):1051-1056.
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Diagnosis: Tuberculoid leprosy.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
The biopsy specimens revealed grouped epithelioid granulomas with a peripheral rim of lymphocytes distributed throughout the dermis and subcutis. The granulomas were arranged arround arrectores pilorum muscles and eccrine glands, and some of them were elongated along the course of the vessels. They contained well-formed Langhans-type giant cells and multinucleate foreign body giant cells. No nerves were identified by hematoxylin-eosin and S100 protein staining. Cultures were negative for bacteria, as were stains for acid-fast bacilli. Electroneurography revealed mononeuropathy of the common peroneal nerve. The Mitsuda reaction was strongly positive. Angiotensin-converting enzyme levels, findings of chest radiography, and serum and urine calcium concentrations were normal. The results of serologic tests for syphilis (rapid plasma reagin tests and Treponema pallidum hemoagglutination assay), a tuberculin test, and mucous nasal bacilloscopy were all negative. Six months of therapy with rifampicin (600 mg/mo) and dapsone (100 mg/d) resulted in a marked improvement of the lesion, . . . [Full Text of this Article] DISCUSSION
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Red Annular Plaque on the Dorsum of the Foot—Quiz Case
Patricia Bassas Freixas, Ramon Bartralot Soler, Domingo Bodet Castillo, Cristina Heras Mulero, Carla Ferrándiz-Pulido, Gloria Aparicio Español, Jordi Mollet Sánchez, and Vicente García-Patos Briones
Arch Dermatol. 2008;144(8):1051-1056.
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