Cutaneous Mycobacterium bovis infection of 40 years' duration

To the Editor.— Mycobacterium bovis infection in man has been controlled, but not completely eradicated, in the industralized world with universal mandatory pasteurization of milk products and screening for tuberculous infection among farm animals. 1 We present a newly diagnosed case of cutaneous M bovis disease of extremely long duration, spanning at least 40 years. Report of a Case.— A 57-year-old white man presented to the Mohs Surgery Clinic at the University of Wisconsin, Madison, for the treatment of actinic keratoses. A right upper arm lesion was incidentally noted. The patient stated that it had been present, asymptomatic and unchanging, ever since he could remember. It had been diagnosed as a hemangioma on several occasions in the past. From childhood through college, he spent a lot of time on a New Jersey farm drinking unpasteurized milk on numerous occasions. There was a long history of positive purified protein derivative