Several scalp ulcerated l...

A 24-year-old male was admitted to the neurosurgery unit with several scalp ulcerated lesions and head oedema dating back 16 months. The patient had no fever but had a history of headaches. His body temperature was 37.5°C, blood pressure was 110/70 mmHg, and heart rate was 65 bpm at the time of admission. A 15 on the Glasgow Coma Scale indicated correct consciousness, and there was no sign of a localised neurological abnormality. Physical examination indicated swelling of the head, many subcutaneous lumps on the scalp, and ulcerated ulcers (Figure 1). Examination of the oral cavity indicated numerous caries and a poor state of oral hygiene. The CT scan (Figure 2) showed several subcutaneous lumps in the scalp and persistent inflammatory alterations in the skull.