case_images: PMC11769843_01
case_images: Clinical photographs illustrating the patient's condition. (a) Initial presentation showing diffuse yellowish plaques on the nape of the neck, shoulders, back, and waist. The plaques had clear boundaries and formed a map-like appearance. The skin texture and hair appeared normal, with a slightly firm consistency that could be palpated without pain or sensory disturbances. (b) Significant improvement of the lesions observed after 8 weeks of treatment. (c) Absence of lesion recurrence during a follow-up visit 4 months after treatment.
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case_images: The patient had a skin-colored fingernail-sized plaque on the right side of the neck 3 years ago without any obvious triggers, with no pain or itching, which did not subside and gradually increased in size and expansion, spreading to the left side of the neck, back, and lumbar area, with a yellowish, well-defined, map-like appearance, and the lesions did not have any breakage, vesiculation, or exudation (Figure 1a). After 8 weeks, the patient's cutaneous sclerosis on the back showed marked improvement, with flattening and regression of plaques (Figure 1b). No recurrence has been observed during the follow-up period (Figure 1c).
case_images: Histopathological features of skin lesions. (a) The epidermis appears mostly normal, with liquefied degeneration of the basal lamina and extensive mucin deposition between the dermal collagen fibers (H&E, magnification x50). (b) Focal fibrosis is observed in the dermis (H&E, magnification x50). (c) Sparse infiltration of inflammatory cells, predominantly lymphocytes and a few fibroblasts is observed around the dermal blood vessels (H&E, magnification x100). (d) Positive staining for Assyntolan is observed (H&E, magnificationx200).
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case_images: PAS staining did not reveal any spores or mycelium (Figure 2a-d). 