Case for diagnosis
A 23-year-old female patient with no comorbidity reports a lesion in the cubital fossa of the superior left arm which has been present for two years. Initially, the lesion appeared as a purulent hyperchromic papule that evolved into a nodular lesion with posterior ulceration and elimination of a liquid substance ( and ).\nShe reported previous use of topical neomicin with no healing. On dermatological examination, a 1.5 x 1.0 cm ulcerated tumor with fibrous consistency, a hyperchromic halo and clean background could be observed in the left cubital fossa. No lymphadenomegaly was found.\nThe following diagnostic hypotheses were posed: leishmaniasis, squamous cell carcinoma, lymphoma, sporotrichosis and dermatofibrosarcoma. An excisional biopsy was performed. Histopathological sections revealed a dermal lesion, formed by big cells, with an abundant granular cytoplasm and a small hyperchromatic nucleus without abnormalities. Malignant signs were absent and the borders were clear of tumor ().