Histologic examination of the biopsy specimen revealed a dense, diffuse infiltrate in the dermis and subcutaneous tissue consisting almost exclusively of granulocytes. Because there was concern regarding an infectious process, a Ziehl-Neelsen stain was performed, which showed numerous acid-fast bacilli (Figure 4). Culture of tissue on Jensen-Löwenstein agar did not yield mycobacteria, but acid-fast bacilli were found in the sputum sample as well as in the smear from an ulcerative lesion on the hand.
Chronic Infiltrates and Persisting Ulcerations on the Arms and Legs—Diagnosis. Arch Dermatol. 2005;141(7):897-902. doi:10.1001/archderm.141.7.897-f