A 56-year-old Filipino male presented to our outpatient clinic with a five-month history of cutaneous ulcerated nodules on the right knee and on the back of right foot which had treated previously been diagnosed and unsuccessfully as vascular ulcers. His medical history showed no treated relevant diseases or treatment. The patient had lived in Italy for many years, but frequently returned home to the Philippines.
Cutaneous findingsSkin examination revealed multiple, non-tender, subcutaneous, warm and ulcerated nodules on the right lower limb with a sporotrichoid-like distribution and caseous discharge after squeezing (Figure 1a, b). Lesion size ranged from about 1 × 1 cm to 4 × 4 cm. Moreover, an ulcerated plaque attached to the subcutaneous tissue and ribs was present