case_images: PMC10505374_01
case_images: (A and B) A 75-year-old male with multiple erythematous papules and plaques on the margins of both hands.
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case_images: Dermatological examination revealed multiple erythematous papules and plaques with subtle scales on the margins of both palms (Figure 1).
case_images: Histopathology: (A) Nodular infiltrate of lymphocytes, histiocytes, multinucleated giant cells with haphazardly arranged thickened collagen in the dermis (Hematoxylin and Eosin, x100). (B) Presence of elastophagocytosis (Hematoxylin and Eosin, x400). (C and D) Increase in fragmented elastic fibers with elastophagocytosis (red arrow) in the upper dermis but decrease in elastic fibers within the granulomatous area (Verhoeff-Van Gieson, x100 and x400 original magnification).
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case_images: A skin biopsy of the lesion on his right palm was done to confirm the diagnosis, which revealed nodular infiltration of lymphocytes, histiocytes, and multinucleated giant cells with elastophagocytosis (Figure 2A and B). Conspicuous degenerated and fragmented elastic fibers stained by Verhoeff-Van Gieson (VVG) were observed in the upper dermis, as opposed to diminished elastic fibers within the granulomatous area (Figure 2C and D).
case_images: PMC10505374_02
case_images: A 68-year-old male with erythematous to brownish annular papules and plaques on the margins of both hands.
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case_images: Dermatological examination revealed multiple erythematous to brownish papules and plaques on the margins of both palms (Figure 3).
case_images: Histopathology: (A) Granulomatous inflammation and thickened degenerative collagen (Hematoxylin and Eosin, x100). (B) Presence of elastophagocytosis (Hematoxylin and Eosin, x400). (C and D) Increase in fragmented elastic fibers with elastophagocytosis (red arrow) in the upper dermis but decrease in elastic fibers within the granulomatous area (Verhoeff-Van Gieson, x100 and x400 original magnification).
case_images: CCID-16-2497-g0004.jpg
case_images: PMC10505374_02_CCID-16-2497-g0004.jpg
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case_images: Histological examination and VVG staining showed findings similar to those in case 1, consisting of granulomatous inflammation, elastolysis, elastophagocytosis, and thickened degenerate collagen (Figure 4A-D).