Cutaneous granulomas masquerading as tuberculoid leprosy in a patient withcongenital combined immunodeficiency

Combined immunodeficiency disorders are characterized by abnormalities in c ellular and humoral immunity. This classification includes common variable immunodeficiency (CVI), a primary immunodeficiency disorder characterized b y hypogammaglobulinemia, recurrent bacterial infections, and significant T- cell abnormalities. Associated autoimmune diseases include rheumatoid arthr itis, pernicious anemia, idiopathic thrombocytopenic purpura, and systemic lupus erythematous. Granulomatous lesions in lymphoid tissues, solid organs , and skin have been reported. We describe a patient with CVI who developed cutaneous granulomas with perineural invasion; to our knowledge, this is a previously undescribed feature.