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What Is Your Diagnosis?

FIGURE 3: Dermal lesion with granular cytoplasm FIGURE 1: Nodular lesion with ulceration in the cubital fossa CASE REPORT A 23-year-old female patient with no comor-bidity reports a lesion in the cubital fossa of the superior left arm which has been present for two years. Initially, the lesion appeared as a purulent hyper-chromic papule that evolved into a nodular lesion with posterior ulceration and elimination of a liquid substance (Figures 1 and 2). She reported previous use of topical neomicin with no healing. On dermatological examination, a 1.5 x 1.0 cm ulcerated tumor with fibrous consistency, a hyperchromic halo and clean background could be observed in the left cubital fossa. No lymphade-nomegaly was found. The following diagnostic hypotheses were posed: leishmaniasis, squamous cell carcinoma, lym-phoma, sporotrichosis and dermatofibrosarcoma. An excisional biopsy was performed. Histopathological sections revealed a dermal lesion, formed by big cells, with an abundant granular cytoplasm and a small hyperchromatic nucleus without abnormalities. Malignant signs were absent and the borders were clear of tumor (Figure 3).