Case Number : CT0040 Adam_Bates

Multiple dermal well formed discreet non-necrotizing epithelioid granulomata with giant cells and rimmed by lymphocytic infiltrate. No vasculitis is seen. Usual DD of cutaneous granulomata for special stains, microbiology, chest X-ray, serum ACE, Ca to exlude infections, sarcoidosis, FB
Also history is imoprtant e.g Crohn's dieaase. (Cutaneous granulomata in crohn's disease my preceed bowel involvment).

Noncaseating granulomas with lymphocytes in deep dermis and extending into subcutis. Site is suggestive of cutaneous Crohn disease.
 

Agree, from the clinical point of view will favor foreign body granulomatous reaction (injection ?) or crohn's ..
 

I would include in the differential diagnosis cutaneous tuberculosis vs Crohn´s vs foreign body granulomatous dermatitis vs sporotrichosis
 

Tuberculosis verrucosa vs Crohn' s disease vs foreign body granulomas
 

Chohn's disease vs foreign body granulomatous disease
 

Granulomatous Immflamation with Giant cell reaction to foreing body.
 

Thanks for all your comments and DDs. This was a case of tuberculosis.