UPMC Dermatopathology "Case of the Month" Presentations
UPP - Department of Dermatology, Dermatopathology Unit
Case Authors: Justin Vujevich MD, Cynthia Mates MD, Drazen Jukic MD
JANUARY 2005 CASE OF THE MONTH
CLINICAL FINDINGS
A 44 y/o African-American female presented to the dermatology clinic with lifelong history of asymptomatic, dark-brown lesions on her dorsal hands and medial feet (Figures 1,2,3). The lesions were not painful, did not bleed, nor were pruritic. Over-the-counter moisturizers did not improve the clinical appearance.
Review of systems was unremarkable. She had no significant past medical history, no family history of similar lesions or autoimmune disease, and was not taking any medications.
Physical Exam
Physical exam revealed hyper-pigmented firm, flat-topped papules on extensors surfaces of the dorsal hands and medial ankles. There were no other appreciable lesions on the trunk, face, or oral mucosa. There were no appreciable nail changes.
3mm punch biopsy was performed on a lesion from the left 5 th dorsal finger.
Hematoxylin and eosin staining demonstrated epidermal hyperkeratosis and hypergranulosis
with a normal appearing dermis (Figures 4,5). An elastic stain revealed fragmented
elastic fibers in the superficial dermis (figure 6).
GO TO FIGURE AND IMAGE REVIEW PAGE
GO TO DISCUSSION AND DIAGNOSIS PAGE
