A previously healthy 36-year-old man had a 10-year history of chronic inflammation of his left leg (Figure 1). Red plaques and abscesses that drained spontaneously gradually developed on his left leg, leaving scars and hypopigmentation and hyperpigmentation. Prolonged oral antibiotic treatment did not control the disease. The findings of the physical examination were otherwise normal. A complete blood cell count, sedimentation rate, blood glucose levels, electrolyte levels, kidney and liver functions, and results of serum protein electrophoresis, VDRL test, and radiography of the legs were all normal. Cultures of material obtained from a fresh abscess were negative for bacteria, fungi, and mycobacteria. A chest radiograph demonstrated an old inflammatory process involving the left lung base. A tuberculin test was nonreactive. A punch biopsy specimen from an early lesion demonstrated an abscess. An excisional biopsy specimen was obtained from the left leg (Figure 2 and Figure 3).
Guberman D, Reinus C, Gilead L, Goldenhersh MA. Chronic Unilateral Leg Inflammation in a Young Man. Arch Dermatol. 1998;134(6):743-748. doi: