Figures Legend:
Figure 1: a, b) Hyperkeratotic erythematous nodular lesions with secondary ulceration and pustules. c) Evolution over time, the lesion became more hyperkeratotic and exophytic. d) black dots on the surface of the lesion, representing sclerotic bodies.
Figure 2: Numerous muriform/sclerotcic bodies seen on KOH examination
Author Contributions: Joe khodeir conceived the study, diagnosed and managed the patient, and drafted the manuscript. Paul ohanian conducted the literature review and contributed to the manuscript writing. Hala Megarbane contributed to the diagnosis and treatment discussion. All authors critically reviewed and approved the final manuscript