A 47-year-old diabetic female from southern Iran, presented with numerous skin lesions (above).
Routine laboratory workup including CBC, serum C3, C4, IgG, IgA, IgM levels were normal. Culture from the lesions resulted in growth of Staphylococcus aureus, and S. epidermidis coagulase negative, with superimposed fungal infection. Chemotherapy with appropriate antibiotics had failed several times.
Her relatives, who believed she had leprosy, put her in isolation. The patient then became depressed and suicidal.
Direct smear and biopsy of the lesions were characteristically diagnostic for her disease. Her condition rapidly improved when the appropriate treatment was implemented.
Your diagnosis?