Abstract
A 30-year-old man presented with a left side diffuse erythematous nodular, nontender, ulcerated auricular and periauricular skin lesion with serosanguineous discharge (Figure 1) after bilateral cervical lymphadenitis, which did not respond to a 6-month antituberculous medical therapy (i.e. isoniazide, ethambutol, rifampin and pyrazinamide) for suspected extra-pulmonary Tuberculosis bacillus (TB) infection. A battery of workup, including serology tests of anti-HIV antibody, CD4/CD8 counts, rheumatoid arthritis factor, human leukocyte antigen-B27, antinuclear antibody, anti-extractable nuclear antigen, cytomegalovirus antibody, cryptococcal antigen, Toxoplasma antibody and Epstein–Barr virus antibody titers were performed but all revealed negative results. Magnetic resonance imaging (MRI) showed multiple abnormally enlarged lymph nodes in the bilateral neck and an infiltrative skin lesion over the left external auricle (Figure 2 …
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