Issue: 2020 > Juli > photo quiz

A tender erythematous facial plaque

D.B. Bhanja, A. Sil, A. Panigrahi
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A 26-year-old gentleman presented with a 3-month history of red-coloured rash over his face. The patient was treated with topical corticosteroid as a case of eczema, before presenting to us. He also complained of fever and joint paint in the preceding one month. Examination revealed a well-demarcated, tender, erythematous, and anaesthetic plaque with a polycyclic margin over the left side of his face. A cord-like, thickened, and tender greater auricular nerve over the left side of his neck was noted (figure 1). A thickened and tender ulnar nerve was documented on his left arm. Laboratory examination was notable for increased erythrocyte sedimentation rate (25 mm/hr, reference range 0-15 mm/ hr). Histopathological examination of the erythematous margin revealed epithelioid granulomas arranged in a curvilinear pattern along the neurovascular bundle (figure 2). Fite-Faraco staining was negative.


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