Case 164. Reference case 164B

　 　 　 　
　 Buruli ulcer (large painless ulcer) caused by Mycobacterium ulcerans, seen in the leg of a Kenyan adult (HE). 　
　 　 　 　

　

 　 Diffuse coagulative necrosis is formed in the dermis though subcutaneous tissue. Undermining ulceration is characteristic. No granulomatous reaction is seen.