Fig. 1.

Initial presentation (elbow papules), (a) Erythematous papules on the left elbow, some showing central umbilication, necrosis or crustations. (b–d) Photomicrographs depicting histopathological features of elbow papules; granulomatous inflammation with interstitial histiocytes (b, H&E original magnification X100), foci of necrobiosis surrounded by histiocytes (c, H&E original magnification X100) and interstitial mucin with neutrophils and nuclear dust (d, H&E original magnification X400).