Contributor’s Morphologic Diagnosis: Skin, chronic multifocal to coalescing granulomatous and necrotizing dermatitis with cutaneous neuritis and epidermal ulceration (consistent with infection with Mycobacterium leprae)

History: This macaque was imported from the Philippines in 1990 to augment the breeding colony at the California Regional Primate Research Center. Four years later she was brought to the attention of the veterinary service because of an equivocal tuberculin reaction and the presence of a skin rash. A follow up skin test using mammalian tuberculin, avian tuberculin and a sterile saline control produced a small induration at 24 and 48 hours to only the avian tuberculin inoculation. The result was considered equivocal for avian and negative for mammalian tuberculosis. She had previously been noted to have intermittent epistaxis, crusting of the nares, ulcerated nasal philtrum and nasal discharge. Thoracic radiographs revealed no significant findings.