Case 52

1. Presented by Nicholas Rogers, MD and reviewed by Nicole Parrish, PhD.

A middle-aged patient with no significant past medical history presents with a pink, scaly, red papule on a finger (Figure 1). The papule has been present for approximately one year and has been growing slowly over that time. The lesion appeared a few weeks after the patient accidently cut their finger, with concurrent exposure to marine water. Laboratory studies including CBC and CMP were unremarkable. No lymphadenopathy or additional skin lesions were noted on physical exam. A biopsy was performed that showed granulomatous and neutrophilic inflammation concerning for an infectious process (Figure 2). PAS, GMS, and AFB stains were negative for microorganisms. A portion of the biopsy was also sent to microbiology where Auramine-Rhodamine and calcofluor white stains were negative.

Figure 1

Figure 2

Question: What is the most likely cause of this lesion?


20 thoughts on “Case 52”

  1. Hello! Do you use Twitter? I’d like to follow you if that would be okay. I’m absolutely enjoying your blog and look forward to new updates.

  2. Yet another thing is that while looking for a good on the net electronics shop, look for online stores that are frequently updated, trying to keep up-to-date with the hottest products, the top deals, and helpful information on product or service. This will make certain you are doing business with a shop which stays ahead of the competition and offers you what you should need to make knowledgeable, well-informed electronics acquisitions. Thanks for the critical tips I have really learned from your blog.

  3. Great beat ! I would like to apprentice while you amend your web site, how could i subscribe for a blog site? The account helped me a acceptable deal. I had been a little bit acquainted of this your broadcast provided bright clear concept

Leave a Reply

Your email address will not be published. Required fields are marked *