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Summer 2020, Vol. 28 No. 2

Hong Kong J. Dermatol. Venereol. (2020) 28, 80-81


Dermato-venereological Quiz

Dermato-venereological Quiz

THB Chan 陳子浩 and TYE Cheung 張天恩

A 58-year-old female patient presented with an itchy rash over the neck, shoulder, abdomen and back for 6 months. The rash was initially erythematous, then became hyperpigmented. She had enjoyed good past health and there were no systemic symptoms.

Physical examination revealed indurated hyperpigmented plaques with an erythematous border over the neck, shoulder, abdomen and sacral regions. There were no palpable cervical, axillary or groin lymph nodes (Figures 1-4). Blood tests including blood count, renal and liver function, ESR, CRP, ANA, RF, anti-ENA, were all normal. There were no Sezary cells in the peripheral blood smear. A skin biopsy was taken from the abdominal lesion (Figures 5 & 6).

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5 Low power view (H&E, original magnification x 40).

Figure 6 High power view (H&E, original magnification x 400).

Questions

  1. What are the differential diagnoses?
  2. What are the histological findings of the skin biopsy?
  3. What is the diagnosis?
  4. What is the treatment?