UPP - Department of Dermatology, Dermatopathology Unit
John Vu, MD, PhD, Justin Haught, MD, Timothy Patton, DO, Joseph English, MD, Jill Buckthal-McCuin MD, Drazen Jukic, MD, PhD
JUNE 2009 CASE OF THE MONTH
A 73-year old white woman with rosacea, eczema, seasonal allergies, who presented to the clinic for a seven-month followup of a slowly resolving lesion on her abdomen, present for approximately a year. She confirms a history of similar lesions in the past without definitive treatments, and had tried clobetasol cream, now only using Elocon. On followup she presented with additional lesions on the arms and legs. These lesions are otherwise not irritated or bothersome to the patient. She had a recent diagnosis (6 to 7 month history) of breast cancer status post mastectomy now on Arimidex. She denied any constitutional symptoms.
The patient had small soft, yellow to brown to erythematous, well-demarcated flat-topped papules over both forearms (Figure 1) and thighs and had a confluent patch/plaque over her right abdomen.
Fasting serum glucose was 89 mg/dL.
H&E revealed multiple ductal collections of hypochromatic epithelial cells, some with cords projecting into a comma-like pattern (Figure 2 to 6). Trichrome (Figure 7) for elastin was also performed showing no elastin fragmentation, such as that seen in pseudoxanthoma elasticum.