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A 56-year-old Indian man presented to us with painful dusky plaques on the left shoulder that began 15 months ago and rapidly progressed to involve the adjacent chest wall and abdomen. The plaques were well defined, tender with a central dusky hue with underlying woody-hard induration (figure 1A). His vitals were stable. Haemogram, peripheral blood smear and serum biochemistry were unremarkable. A skin biopsy showed suppurative granulomas in the dermis. Septate acute-angled branched hyphae were identified …
Contributors All authors have contributed sufficiently. RB and SY managed the case and made the diagnosis, clinically. RB submitted the manuscript. NP wrote the manuscript and managed the case. ARM made the histopathological diagnosis and provided photomicrographs.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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