下肢蜂窩組織炎是臨床上常見的伺機性細菌感染病症，多續發於足部之微小傷口。我們報告一48歲男性，左下肢反復發生蜂窩組織炎。理學檢查見患者左小腿外側有一片具壓痛、界線不甚清楚之紅色腫脹斑塊，該足底呈現廣泛角化合併多處具組織滲液的皸裂傷口應是其肇因。蜂窩組織炎以抗生素治療獲得控制後，於足底之皮膚切片顯示表皮層過度角化，不現則棘細胞增生；真皮層見肉芽腫性發炎反應及蘭格罕氏巨細胞；抗酸染色油鏡檢查，見極少數散在之分枝桿菌；經給予抗結核藥物治療反應極佳。根據病史，臨床表徵，病理變化，文獻回顧及良好之抗結核藥物治療反應，符合疣狀皮膚結核之診斷。痊癒後，追蹤三年，未再復發下肢蜂窩組織炎及疣狀皮膚結核。

Cellulitis of lower extremities is frequently encountered and results from a breach of the skin and inoculation of opportunistic bacteria. We report a case of recurrent cellulitis of left lower limb in a 48-year-old man, complicated from the left foot lesion. The plantar aspect showed a diffuse verrucous surface with numerous fissures and serous discharge. The cellulitis subsided after administration of first line antibiotic. Histopathological examination of left sole revealed marked hyperkeratosis, irregular acanthosis of the epidermis and a granulomatous inflammation with Langhans ginat cells over upper dermis. Scanty acid-fast bacilli were found by acid-fast stain. After two week treatment with anti-TB drugs, warty surface improved remarkably and healed two months later. The history, clinical presentations, histopathological characteristics, the good response to anti-TB drugs and literature review were all suggest the diagnosis of tuberculosis verrucosa cutis. Neither cellulitis nor tuberculosis verrucosa cutis relapsed during the follow-up of 3 years.