REPORT OF A CASE
A 22-year-old man presented with a 3-year history of a solitary red nodule on the dorsal aspect of his left great toe. The nodule arose shortly after the patient injured himself on a nail in his attic. The nodule initially grew rapidly, but then remained relatively unchanged for over 2 years. It was slightly tender and occasionally bled when traumatized. One year before he presented to us, he underwent treatment with an injection of a corticosteroid, which initially reduced the size of the lesion. However, the lesion quickly regrew.Examination of the patient's left great toe revealed a 1.8×1.2-cm dark red, slightly crusted and friable nodule containing a few small sinus tracts (Fig 1). A skin punch biopsy specimen revealed noncaseating dermal granulomas (Fig 2) and was negative for organisms with acid-fast bacilli and fungal stains. Tissue cultures for bacteria, fungi, and mycobacteria were also negative.
Murdock DK, Sexton M, Marks JG. Persistent Nodule on the Toe Following Trauma. Arch Dermatol. 1992;128(6):851-852. doi:10.1001/archderm.1992.01680160135023