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?
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.
Treatment with rifampin, izoniazide, and pyrazinamide was begun. At the
Renfro L, Miller D, Raszi L, Kamino H. Persistent Plaque on the Shoulder of a Chinese Woman. Arch Dermatol. 1993;129(2):236. doi:10.1001/archderm.1993.01680230123020
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