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July 2005

Chronic Infiltrates and Persisting Ulcerations on the Arms and Legs—Diagnosis

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Arch Dermatol. 2005;141(7):897-902. doi:10.1001/archderm.141.7.897-f

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.

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