Case for Diagnosis DOI: 10.1111/ddg.13436 A large mass and erythematous-violaceous plaques History A 55-year-old man presented with a two-month history of a bruise-like large mass on his abdomen (Figure 1). Physical examination revealed a large violaceous abdominal plaque (6 cm in diameter) surrounded by an erythematous halo and numerous erythematous-violaceous papules and nodules on the face, trunk, and extremities (Figure 2). While none of the lesions was pruritic or painful, the sudden occurrence gave cause for concern, prompting the patient to seek medical at- tention. He reported no fever, fatigue, or weight loss. Blood tests revealed an increase in lactate dehydrogenase levels (> 500 U/L) and ESR (> 40); white blood cell count, electro- phoresis, and all other parameters were within normal limits. HIV, hepatitis, and syphilis tests were negative. Histopathology Histology of a punch biopsy from the abdominal plaque re- vealed a monomorphic dermal infiltrate of blasts, sparing the Figure 2 Erythemato-violaceous plaques on the back. epidermis. On immunohistochemistry, the neoplastic cells expressed LCA/CD45, CD4, BCDA-2/CD303, and CD123. In addition, a high proliferation index (MIB-1/Ki-67 > 75 %) Figure 1 A large bruise-like tumor on the abdomen. was noted (Figure 3a–f). © 2018 Deutsche Dermatologische Gesellschaft (DDG). Published
Journal Der Deutschen Dermatologischen Gesellschaft – Wiley
Published: Jan 1, 2018
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