case_images: PMC8714461_01
case_images: Skin lesions observed on the third visit before diagnosis. (A) Red to yellow papules on her left cheek, measuring approximately 3 cm x 3 cm. (B) Papules and erythema on her left chest, measuring approximately 6 cm x 3.5 cm.
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case_images: The surface was smooth and had a waxy luster (Figure 1A). A similar rash was seen on the left chest, covering an area of approximately 6 cm x 3.5 cm with a clear boundary, smooth surface, waxy luster, mild infiltration and hypertrophy, normal skin temperature, and no tenderness (Figure 1B).
case_images: Epidermis is generally normal. Cell masses can be seen infiltrating the dermis. Phagocytosis of histiocytes can be seen; the cytoplasm appears pale and frothy, and some nuclei are deeply stained and irregular in shape. (40X).
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case_images: Lymphocytes, plasma cells, a small number of neutrophils and eosinophils were observed in the mass upon hematoxylin and eosin (HE) staining (Figure 2).
case_images: Highly magnified (400x) microscopic image shows emperipolesis.
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case_images: Emperipolesis phenomenon was also observed (Figure 3).
case_images: Immunohistochemical (staining) findings. (A) S100 (+) (40x). (B) CD68 (+) (40x). (C) CD1a (-) (40x).
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case_images: IHC staining showed S100 (+) (Figure 4A), CD68 (+) (Figure 4B), and CD1a (-) (Figure 4C).
case_images: Three months after diagnosis, skin lesions partially disappeared. (A) Papules on the left cheek disappeared, but erythema (approximately 3 cm x 3 cm) is noted. (B) Papules on left chest were smaller in size (approximately 5 cm x 3 cm).
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case_images: No treatment was initiated and the skin lesions partially disappeared three months after diagnosis (Figure 5A and B).
case_images: Timeline.
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case_images: The patient is still being monitored via follow-up examinations (Figure 6).