Acta Dermato-Venereologica 99-10CompleteContent | Page 33
935
Dense Papules on the Face: A Quiz
Hongmei ZHOU, Qiang ZHAO, Lihong ZHAO, Qian SHANG, Jing LI and Songmei GENG*
Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an 710004, China. *E-mail:
[email protected]
A 28-year-old man presented with multiple asymptomatic
papules and plaques on his face for 3 months. He denied
any drug intake, allergy or trauma history. A dermatological
examination revealed clusters of yellowish-erythematous
papules and plaques on his face and scalp (Fig. 1). No
lymphadenopathy or visceromegalies were found. Rou-
tine laboratory tests, chest radiography and abdominal
ultrasound revealed no obvious abnormalities. Biopsy of
a lesion from his cheek showed a nodular mixed inflam-
matory infiltrate throughout the dermis (Fig. 2a). The
infiltration consisted of clustered large foamy-appearing
histiocytes, numerous lymphocytes, plasma cells and few
neutrophils. Emperipolesis in histiocytes was noted (Fig.
2b). Immunohistochemical studies showed that the pale
cells were positive for S100 (Fig. 2c) and CD68, but nega-
tive for CD1a. Specific stainings for microbial infections
were negative.
What is your diagnosis? See next page for answer.
Fig. 1. Clusters of yellowish-erythematous papules, which partially coalesced
into verrucous plaques on the patient’s face and nearby scalp. Written
permission from the patient is given.
QUIZ SECTION
Fig. 2. (a) A dense nodular mixed inflammatory infiltrate in the dermis and subcutaneous tissue (haematoxylin and eosin;
HE ×100). (B) The infiltration consisted of mainly large histiocytes with emperipolesis (black arrow), lymphocytes, and few
neutrophils (HE ×400). (C) S100-protein was positive and confirmed emperipolesis (white arrow) (immunohistochemistry;
IHC ×400).
This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta
Journal Compilation © 2019 Acta Dermato-Venereologica.
doi: 10.2340/00015555-3192
Acta Derm Venereol 2019; 99: 935–936