case_images: PMC10725833_01
case_images: Clinical images and relevant examination results obtained during the patient's initial visit to our hospital. (a and b) Skin examination unveiled infiltrative symmetrical Orange or brown patches with distinct borders on the inner canthi as well as upper and lower eyelids. The surface was smooth, devoid of scales, atrophy, erosion, or necrosis, and exhibited no tenderness. (c) The epidermis displayed mild hyperplasia, while the dermis exhibited a conglomerate of foam cells, histiocytes, and multinucleated giant cells. Additionally, a minor lymphocytic infiltration was observed around the dermal blood vessels and adnexal structures adjacent to the conglomerate (H and Ex50). (d) Intense lymphoplasmacytic infiltration was observed (H&E, magnification x200). (e) Negative result for S100 immunohistochemistry (magnification x200). (f) Absence of CD1a immunohistochemical staining (magnification x200). (g) Positive immunohistochemical staining for CD68 (magnification x200). (h and i) The axial contrast-enhanced orbital CT scan revealed no abnormalities in either eye. Swelling of the subcutaneous soft tissue was noted in the bilateral maxillofacial region and eyelids, with a subtle prominence on the right side.
case_images: CCID-16-3575-g0001.jpg
case_images: PMC10725833_01_CCID-16-3575-g0001.jpg
case_images: f0001
case_images: Subsequently, the mass slowly expanded and grew, accompanied by persistent burning sensations (Figure 1a and b). Subsequent biopsy of the right periorbital plaque displayed histological findings of mild epidermal hyperplasia, a granulomatous mass containing foam cells and histiocytes within the dermis, as well as concurrent collagen hyperplasia and perivascular lymphocytic infiltration primarily composed of inflammatory cells (Figure 1c and d). Immunohistochemical results indicated positive staining for CD68, while S100 and CD1a were negative (Figure 1e-g).  Whole-body CT ruled out systemic involvement (Figure 1h and i).