QUIZ SECTION
161 Advances in dermatology and venereology
ActaDV Acta Dermato-Venereologica ActaDV
Long-standing Verrucous Plaques on the Buttocks : A Quiz
Dong Hyuk EUN , Jun Young KIM , Yoon Hyuk CHOI and Yong Hyun JANG * Department of Dermatology , Kyungpook National University School of Medicine , 130 , Dongduk-ro , Jung-gu , Daegu , Republic of Korea . * E-mail : yhjang @ knu . ac . kr
A 43-year-old Asian woman presented to our clinic with mildly pruritic hyperkeratotic and verrucous erythematous plaques and peripherally hyperpigmented patches on the left buttock and intergluteal cleft ( Fig . 1a ). She reported onset of the skin lesions occurring approximately 20 years earlier . The lesions had gradually increased in size and thickness , accompanied by mild pruritus . There was no improvement on treatment with oral medication , including several years ’ treatment with corticosteroid and antihistamine . Her personal and family medical histories were unremarkable . Physical examination was normal , with no evidence of lym phadenopathy . Complete blood cell count , C-reactive protein level , and erythrocyte sedimentation rate were also normal . Serologies for human immunodeficiency virus , syphilis , and hepatitis virus were negative . Chest radiography and KOH examination of the skin lesion showed non-specific results . Histopathological examination of the plaques revealed acanthosis in the epidermis , dense inflammatory cell infiltration consisting of neutrophils , lymphocytes , and perivascular infiltration in the superficial dermis ( Fig . 1b ).
What is your diagnosis ? See next page for answer .
Fig . 1 . ( a ) Hyperkeratotic erythematous plaques and peripherally hyperpigmented patches on the left buttock and intergluteal cleft .( b ) Irregular acanthosis and dense lymphohistiocytic infiltration with granulomatous inflammation ( hematoxylin and eosin ( H & E ) staining , original magnification × 100 ).
This is an open access article under the CC BY-NC license . www . medicaljournals . se / acta Journal Compilation © 2018 Acta Dermato-Venereologica . doi : 10.2340 / 00015555-2792 Acta Derm Venereol 2018 ; 98 : 161 – 162