Slow-growing scaly erythematous plaque on the face and scalp of an elderly woman.

At low magnification, a biopsy specimen from the edge of the lesion showed a slightly acanthotic and ulcerated but otherwise unremarkable epidermis as well as a granulomatous inflammatory infiltrate throughout the full thickness of the dermis and subcutaneous tissue. The granulomas had a lymphocytic corona (Fig. 2). Higher magnification revealed basophilic dot-like structures in the cytoplasm of many histiocytes (Fig. 3) and Giemsa staining showed these structures to be cytoplasmic inclusion bodies without capsules.