Interesting journal findings

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Physical examination of this child showed an otherwise healthy and weighted 21

kg. Chest X-ray and abdominal ultrasonography were normal, as well as blood

biochemistry exams and blood cell count.

Clinical diagnosis included numular eczema, lymphomatoid papulosis, sarcoidosis

and persistent reaction due to insect bite.

Histologic examination of five different lesions, excised on different

occasions, disclosed similar findings (Fig. 5), i.e. acanthosis, spongiosis and

lymphocyte exocytosis. Intense dermal inflammatory infiltrate with casts of

epithelioid and multinucleated Langhan`s giant cells, surrounded by a variable

number of lymphocytes, characterizing a granulomatous response was present.

Grocott and acid-fast stainings, as well as immunohistochemical ABC–peroxidase

reaction using antibodies against H. capsulatum antigens resulted negative in

all specimens. Diagnosis of a chronic granulomatous dermatitis was established,

leading to new diagnostic hypothesis: paucibacillar leprosy, sarcoidosis,

cutaneous tuberculosis, cutaneous T-cell lymphoma " slack skin " type and some

kind of deep seated mycosis.

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