case_images: PMC5651126_01
case_images: Clinical examination found multiple scalp erosions and crusted plaques.
case_images: CRIDM2017-1536434.001.jpg
case_images: PMC5651126_01_CRIDM2017-1536434.001.jpg
case_images: fig1
case_images: The rest of the scalp was covered with erosions and crusted plaques (Figure 1).
case_images: Excision revealed a variably atrophic epidermis with an impressive horn-like crust containing neutrophilic debris (H-E 2x).
case_images: CRIDM2017-1536434.002.jpg
case_images: PMC5651126_01_CRIDM2017-1536434.002.jpg
case_images: fig2
case_images: Excision revealed a variably atrophic epidermis with an impressive crust containing neutrophilic debris (Figure 2).
case_images: In areas, the material was revealed to have birefringent filamentous areas and a crystalline appearance (H-E 20x).
case_images: CRIDM2017-1536434.003.jpg
case_images: PMC5651126_01_CRIDM2017-1536434.003.jpg
case_images: fig3
case_images: High power examination of the horn-like crust revealed numerous neutrophils, bacterial (coccal) colonies, and strikingly pale eosinophilic material (Figure 3). On close examination, this material was revealed to have birefringent filamentous areas and a crystalline appearance (Figure 3).
case_images: Neutrophils infiltrate the superficial layers of the epidermis. The dermis showed a mixed chronic inflammatory response and some dermal fibrosis.
case_images: CRIDM2017-1536434.004.jpg
case_images: PMC5651126_01_CRIDM2017-1536434.004.jpg
case_images: fig4
case_images: The dermis showed a mixed chronic inflammatory response and some dermal fibrosis (Figure 4).