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