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  Indian J Med Microbiol
 

Figure 1: (a) The lesions showed numerous discrete-to-confluent, skin-colored, papulonodules on the face, forehead, nasolabial folds, and neck. (b) Multiple skin colored nodules on the dorsal hands with joints deformity. (c) Radiograph of the bilateral hands showing joint space narrowing and erosive changes involving the distal interphalangeal and proximal interphalangeal joints (white arrows) along with soft-tissue swelling. (d) Skin pathology of right elbow skin showed abundant foamy cell infiltration in the dermis and extending into the epidermis (H and E stain, ×20). (e) High-power image demonstrated numerous foamy histiocytes (H and E stain, ×200). (f) Positive CD68 immunostaining (×100). (g) Computed tomography of the chest revealed anterior mediastinal lymphadenopathy (green arrow)

Figure 1: (a) The lesions showed numerous discrete-to-confluent, skin-colored, papulonodules on the face, forehead, nasolabial folds, and neck. (b) Multiple skin colored nodules on the dorsal hands with joints deformity. (c) Radiograph of the bilateral hands showing joint space narrowing and erosive changes involving the distal interphalangeal and proximal interphalangeal joints (white arrows) along with soft-tissue swelling. (d) Skin pathology of right elbow skin showed abundant foamy cell infiltration in the dermis and extending into the epidermis (H and E stain, ×20). (e) High-power image demonstrated numerous foamy histiocytes (H and E stain, ×200). (f) Positive CD68 immunostaining (×100). (g) Computed tomography of the chest revealed anterior mediastinal lymphadenopathy (green arrow)