Abstract
A 13-year-old girl came to our clinic in rural southwest Uganda in October, 2000, with a 7-year history of a painless, crusted, skin lesion involving her upper lip and nasal vestibule (figure, top). The lesion had started as a sore in her right nostril and spread to the extent that it made her a social outcast and she had stopped going to school. Her HIV serostatus was unknown, but she denied any sexual contact or blood transfusion. She had always lived locally, had not received BCG vaccination, and had no known active tuberculosis or leprosy contact.
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