case_images: PMC9969724_01
case_images: Clinical manifestation of erythematous pruritic papules located on the left pretibial surface of an 80-year-old female patient.
case_images: 1806-9460-spmj-135-01-76-gf1.jpg
case_images: PMC9969724_01_1806-9460-spmj-135-01-76-gf1.jpg
case_images: f1
case_images: An 80-year-old Caucasian female patient presented with a two-year history of intensively itching skin rash located on her left lower leg and mild swelling of the proximal interphalangeal and metacarpophalangeal joints, accompanied by morning stiffness around these joints, lasting at least one hour before maximal improvement (Figures 1A and 1B). Presence of intensively pruritic erythematous papules located on the left pretibial surface was established clinically (Figures 1A and 1B).
case_images: (A) Histopathological findings: focal acanthosis, subepithelial pink-stained structures and mild to moderate mononuclear infiltrate around single vessels (hematoxylin-eosin staining); (B and C) Subepithelial Congo red-positive deposits showing blue-green birefringence under polarized light.
case_images: 1806-9460-spmj-135-01-76-gf2.jpg
case_images: PMC9969724_01_1806-9460-spmj-135-01-76-gf2.jpg
case_images: f2
case_images: Histopathological evaluations on skin biopsies revealed hyperkeratosis, focal acanthosis, subepithelial structures that stained pink with hematoxylin-eosin and mild to moderate mononuclear infiltrate around single vessels (Figure 2A). Subepithelial Congo red-positive deposits were also observed (Figures 2B and 2C), which showed blue-green birefringence under polarized light.
case_images: PMC9969724_02