REPORT OF A CASE
A 59-year-old black man with borderline hypertension and gout presented with the complaint that quiescent faded scars on his face, trunk, and extremities obtained from minor childhood injuries had suddenly become prominent and erythematous. He had been taking dyazide and allopurinol for several years. His family had no history of any skin diseases.Physical examination revealed firm, erythematous, nodular, minimally tender papules and plaques at sites of previous trauma (Fig 1).The biopsy specimen obtained from a lesion on his right thigh demonstrated multiple, well-demarcated, large, non-caseating, epithelioid granulomas with histiocytes and multinucleated giant cells (Fig 2). Special stains for acid-fast bacilli and fungi were negative as was polarization for foreign bodies.Additional laboratory investigations included complete blood cell count and sequential multiple analyzer, which showed normal results, and a chest roentgenogram (Fig 3).What is your diagnosis?
Although he had no pulmonary symptoms, the chest