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Acudió por presentar múltiples nódulos inflamatorios, con ulceración central en dorso de mano y antebrazo derecho, de distribución esporotricoide de 15 días de evolución; después de presentar herida periungueal en contacto con agua estancada (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). Se procedió a la biopsia y cultivo de la lesión. El estudio histológico evidenció reacción granulomatosa epiteloidea celular acompañada de neutrófilos (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>). No se evidenciaron gérmenes patógenos en la biopsia, siendo las tinciones de Ziehl-Neelsen y PAS, negativas. Se inició tratamiento empírico con minociclina 100<span class="elsevierStyleHsp" style=""></span>mg/12<span class="elsevierStyleHsp" style=""></span>h. Los resultados del cultivo demostraron positividad por <span class="elsevierStyleItalic">Mycobacterium marinum</span>. 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