38-year-old man, who is a farmer from Oromia region, Ethiopia, presented with slowly spreading lesions which started from the right hand and spread diffusely to involve all the right arm, around 6 yr.yrs duration. He denied any trauma history or contact with TB. On examination, exhibited, hyperpigmented, crusted, verrucous plaques, ulcerated with the largest measuring 5 cm × 4 cm and swelling of same area [figure 1]. Not identified LAP on in all accessible area. A 6 months back a patient was visited tothe dermatology out patient clinic for a similar compliant figure [2]complaint [figure 2], and after a punch biopsy was taken onfor a histopathological examination, the section showed Orthorth hyperkeratotic epidermis and irregular acanthotic epidermis, with spongiosis and thickening granular layer and, superficial and deep dermis perivascular and periadnexal lymphoplasmacytic infiltration, and aggregates of histocytes. exhibitedExhibited granulomatous reactions, unfortunately a patientsthe patient’s histology slide couldn’t find. basedBased on this finding, we considered the differcial diagnose to Cutaneouscutaneous sarcoidosis and tubercles cuts verrucous. afterAfter a case discussion, the patient was put on anti tuberculosisanti-tuberculosis agent and comecame back to hospital with out improvement. afterAfter that excisional biopsy was taken for histopathological examination, the section showed a golden-brown, thick-walled, spherical bodies about 6-12 μ in size suggestive of copper-penny/sclerotic bodies/Medlarbodies/medlar bodies of CBM.[figure 3, 4, 5).
Fungal culture was not done. CBC, OFT, chest and hand x-rayx-rays were normal.