Unique CORO1A clinical phenotype in P1: cutaneous ulcerations and histopathology of tuberculoid leprae with caseating granulomas from skin biopsies from CORO1A P1, index case. Skin lesions, shown from upper extremities (Panel A. and B., respectively), were insensitive to pain despite disseminated granulomas and ulcerations. Histopathology (Panel C.) revealed subcutaneous necrotizing caseating granulomas with perineural involvement. Rare acid fast bacilli (AFB) were identified (Panel D.). Perineural granulomas by histopathology with rare AFB and skin lesions insensitive to pain were consistent with tuberculoid leprae due to Mycobacterium leprae. (Department of Pathology, Texas Children's Hospital and the National Hansen's Disease Programs, Baton Rouge, Louisiana)