case_images: PMC5726683_01
case_images: Tumors, eyebrow and hairline alopecia
case_images: abd-92-05-s1-0073-g01.jpg
case_images: PMC5726683_01_abd-92-05-s1-0073-g01.jpg
case_images: f1
case_images: On clinical examination, he had brown and edematous plaques on the frontal region, associated with alopecia of the eyebrows and hairline, in addition to a deforming tumor on the nose (Figure 1).
case_images: Plaques on the trunk and tumors on the upper limbs
case_images: abd-92-05-s1-0073-g02.jpg
case_images: PMC5726683_01_abd-92-05-s1-0073-g02.jpg
case_images: f2
case_images: Slightly lichenified brown plaques were seen on the upper and lower limbs, predominantly on the trunk and ulcerated tumors on the upper limbs (Figure 2).
case_images: Psoriasiform epidermal hyperplasia, predominantly lymphocytic
  folliculotropic infiltrate, loose epithelioid granulomas
  (A: Hematoxylin & eosin, X100); lymphocytic
  infiltrate involving the remaining external follicular sheaths
  (B: Hematoxylin & eosin, X100)
case_images: abd-92-05-s1-0073-g03.jpg
case_images: PMC5726683_01_abd-92-05-s1-0073-g03.jpg
case_images: f3
case_images: In July 2015 three new biopsies from different skin lesions were taken and the histopathology of the abdominal plaque revealed a dense atypical mononuclear infiltrate, involving the remaining follicular sheath and eccrine glands associated to psoriasiform hyperplasia of the epidermis and granulomatous reaction (Figure 3).
case_images: Cytokeratin (AE1/3) positivity in epithelial elements, highlighting the
  destruction of the adnexal epithelium by tumor cells
  (Immunohistochemistry, X40)
case_images: abd-92-05-s1-0073-g04.jpg
case_images: PMC5726683_01_abd-92-05-s1-0073-g04.jpg
case_images: f4
case_images: T-cell cutaneous lymphoma, CD4 and CD30 positive (Figures 4 and 5). The patient was seen by the hematology team and chemotherapy with gemcitabine and interferon, associated to phototherapy were scheduled.
case_images: Predominance of CD4+ population (Immunohistochemistry, X40), mainly of
  large cells; CD30+ (Immunohistochemistry x100) of large cells with more
  atypia around vessels and appendages; CD8+ (Immunohistochemistry, X40)
  in some lymphocytes; CD3+ e CD5+ (Immunohistochemistry, X100) in most
  lymphoid cells; Ki-67+ (MIB1) in about 50% of nuclei
  (Immunohistochemistry, X400)
case_images: abd-92-05-s1-0073-g05.jpg
case_images: PMC5726683_01_abd-92-05-s1-0073-g05.jpg
case_images: f5
case_images: T-cell cutaneous lymphoma, CD4 and CD30 positive (Figures 4 and 5). The patient was seen by the hematology team and chemotherapy with gemcitabine and interferon, associated to phototherapy were scheduled.