case_images: PMC5458363_01
case_images: The patient on initial presentation. Tan papules were noted on (a) the right neck, (b) the left neck, and (c) the superior back and shoulders.
case_images: CRIDM2017-5918708.001.jpg
case_images: PMC5458363_01_CRIDM2017-5918708.001.jpg
case_images: fig1
case_images: On examination, the patient was found to have scattered tan papules of the neck, back, and shoulders bilaterally (Figure 1).
case_images: Histopathological slides. At 2x magnification (a), there are superficial periadnexal and interstitial granulomatous infiltrates (black arrow). The epidermis is slightly attenuated with subjacent papillary dermal fibrosis (white arrow). At 20x magnification, the superficial dermis (b) contains well-formed granulomas (black arrow) and individual histiocytes that are scaffolded in between collagen bundles; scattered eosinophils are present (white arrow). In the mid dermis (c), there are numerous interstitial histiocytes in small clusters (black arrow) and solitary units (white arrow). Colloidal iron stain (d) reveals interstitial deposition of dermal mucin (black arrow).
case_images: CRIDM2017-5918708.002.jpg
case_images: PMC5458363_01_CRIDM2017-5918708.002.jpg
case_images: fig2
case_images: The specimen showed a superficial dermal scar and underlying dermis containing prominent histiocytes with polygonal and cuboidal cytoplasm, in addition to collagen bundles of the superficial and mid dermis (Figure 2).