Arianna Lamberti
Dermatology University of Siena, Italy
Posters & Accepted Abstracts: Surgery Curr Res
A 45 years-old man, came to our observation because of a 2 months history of a papular lesion on the right upper lip, gradually enlarged and evolved into an ulcer. Later, other papules have appeared on the face and neck, which he attributes to insect bites. Dermatological examination revealed multiple ulcerated nodules, varying in size (maximum diameter of 2 cm), round or elliptical, yellowish-brown in color, with raised and clear borders and a central necrosis; located on the left forehead, both nasal ala, and nasolabial fold. The lesions were tender and painless. The patient had no fever and there were no enlarged lymph nodes. No other abnormalities, except cutaneous lesions, were appreciated during a physical examination. Past medical history revealed HAV infection; recurrent episodes of labial herpes simplex and oral candidiasis and numerous episodes of diarrhea in the last 4 months. A biopsy was taken from the lesion and its microscopic examination showed two types of histopathologic reaction: gelatinous type, made up of thick-walled spores organized in aggregates; and granulomatous one, characterized by a pronounced tissue reaction made up of histiocytes, giant cells, lymphoid cells, and fibroblasts. Moreover, the exudate drained from the nodule was been cultured on Sabourad glucose-agar with the addition of chloramphenicol and after 2 days??? growth, cream-like colonies were seen. Histopathological and microbiological findings allowed us to make the right diagnosis.
E-mail: ariannalamberti@virgilio.it
