Granulomatosis Disciformis of Miescher. Presented by Dr. Francesco Ronchese.
A husky 42-year-old instructor in auto driving was seen in 1953 with phlebitis on his left thigh. Subsequently he developed three round eczematoid patches, measuring 1 by 1 cm. in diameter, on his legs. He moved to San Francisco a few months later, and he claims that the patches enlarged, increased in number, and became uncomfortable. Dr. Winer, in 1955, made a diagnosis of granulomatosis disciformis progressiva et atrophica of Miescher. A biopsy specimen of one of the lesions showed a histological picture similar to erythema induratum. The tuberculin test at 1:1000 dilution was negative. Coccidiomycin test was negative. The trichophytin test was strongly positive. No organisms could be cultivated from lesions. Various antibiotics, including Terramycin, intramuscularly administered Combiotic, staphylococcic vaccine, and hydrocortisone, had no effect.
His family history revealed that his mother had been diabetic in her