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February 1993

Persistent Plaque on the Shoulder of a Chinese Woman

Author Affiliations

New York (NY) University Medical Center

Arch Dermatol. 1993;129(2):236. doi:10.1001/archderm.1993.01680230123020

REPORT OF A CASE  A 48-year-old Chinese woman presented with a large plaque on her left shoulder. The plaque had developed at the age of 10 years, when she received a bacille Calmette-Guérin (BCG) vaccine on her left shoulder.The findings from her physical examination showed a 10× 12-cm erythematous and scaling firm plaque with a raised reddish border on the left deltoid area (Fig 1). A biopsy specimen was obtained from that site (Figs 2 and 3). The chest roentgenogram and the examination of the lymph nodes showed normal findings, and an acid-fast bacillus culture was negative.What is your diagnosis?

DIAGNOSIS:  BCG granuloma.

HISTOPATHOLOGIC FINDINGS  The hematoxylin-eosin-stained section of the patient's lesional skin revealed a dense tuberculoid granulomatous inflammation. The Fite stain on multiple serial sections revealed one acid-fast bacillus.

CLINICAL COURSE  Treatment with rifampin, izoniazide, and pyrazinamide was begun. At the

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