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A 1-year-old boy of Afghani origin was referred to the Department of Dermatology due to inflamed nodular lesions on his cheeks. He also had a tendency to bilateral hordeolum on the upper and lower eyelids, which was being followed up by an ophthalmologist. Three violaceous, small, nodular lesions were observed on the right cheek and similar minor lesions on the left cheek (Fig. 1). He had no lymph node swelling on his neck. Bacterial investigations were negative for atypical mycobacteria. A skin punch-biopsy from his cheek was performed, and standard histology revealed a stratum corneum with slight hyperkeratosis. Epidermis was hyperplastic with minimal spongiosis. A granulomatous inflammation was accentuated in the reticular dermis. Treatment with oral penicillin V and topical corticosteroids combined with disinfectants had no effect. What is your diagnosis? See next page for answer.

Inflamed Nodular Lesions on the Cheeks in a One-year-old Boy: A Quiz