S12C19P9-1: This ragged portion of skin, and subcutaneous fat shows areas of necrosis (pale, acidophilic, acellular zones) in the subcutis and in the dermis. The infiltrates at the periphery of the zones of necrosis are granulomatous. The basic patterns are consistent with those of classic erythema induratum (tuberculosis-related panniculitis - necrotizing, lobular and granulomatous panniculitis). Over the years, erythema induratum has been variously defined. In some periods, the diagnosis has included tuberculous and non-tuberculous variants. In other periods, the non-tuberculous category has been characterized as nodular vasculitis. Currently, there is an upswing in the diagnosis of erythema induratum, with the deciding factor being the demonstration of mycobacterial antigens by DNA analysis.

S12C19P9-3: The infiltrates are granulomatous with occasional multinucleated giant cells. There is a small cluster of neutrophils just to the right of the center of the field. In the face of the combined histologic features (granulomatous and suppurative qualities) and in the absence of demonstrable acid fast organisms on special stains, the burden would be on the clinician to rule out an infectious process.

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