case_images: PMC10758199_01
case_images: Multiple infiltrated erythematous papules and plaques on her arms and trunk.
case_images: fmed-10-1291941-g001.jpg
case_images: PMC10758199_01_fmed-10-1291941-g001.jpg
case_images: fig1
case_images: Physical examination showed multiple, infiltrated erythematous papules and plaques with sclerosis and tenderness involving the arms, anterior chest, and abdomen (Figure 1).
case_images: (A) Biopsy of the right upper arm and breast showed nodular and diffuse spindle cell infiltration with collagen hyperplasia and perivascular lymphocytic inflammation in the dermis (hematoxylin-eosin, original magnificationx40). (B) Immunohistochemical staining showed loss of CD34+ dermal dendritic cells in dermis (CD34+ staining, original magnification x 40). (C) Alcian blue staining showed mucin deposition (original magnificationx40). (D) Verhoeff-Van Gieson staining showed the loss of elastin fibers (original magnification x 40).
case_images: fmed-10-1291941-g002.jpg
case_images: PMC10758199_01_fmed-10-1291941-g002.jpg
case_images: fig2
case_images: Two biopsy specimens taken from the right upper arm and breast demonstrated nodular and diffuse spindle cell infiltration with collagen hyperplasia and perivascular lymphocytic inflammation in the dermis (Figure 2A). Immunohistochemical staining showed that the spindle cells were negative for CD34 and cytokeratin, and mucin deposition was identified by Alcian blue staining (Figures 2B,C). Verhoeff-Van Gieson staining demonstrated the loss of elastin fibers (Figure 2D).