Indian Journal of Dermatology
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Year : 2014  |  Volume : 59  |  Issue : 4  |  Page : 419-420
Persistent eczematous lesions over the body


1 Department of Dermatology, Father Muller Medical College and Hospital, Kankanady, Mangalore, Karnataka, India
2 Department of Pathology, Father Muller Medical College and Hospital, Kankanady, Mangalore, Karnataka, India

Date of Web Publication27-Jun-2014

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.135514

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How to cite this article:
Bhat RM, Pinto HP, Kini RG, George L. Persistent eczematous lesions over the body. Indian J Dermatol 2014;59:419-20

How to cite this URL:
Bhat RM, Pinto HP, Kini RG, George L. Persistent eczematous lesions over the body. Indian J Dermatol [serial online] 2014 [cited 2019 Sep 16];59:419-20. Available from: http://www.e-ijd.org/text.asp?2014/59/4/419/135514


A 55-year-old Indian male presented with a history of asymptomatic brown-black patches over the body of 25-year duration. The lesions appeared first over the right thigh and later, gradually over the next few years progressed to involve the whole body with an increase in the number of lesions in the last 5-years. No history of drug intake prior to onset of these lesions. No history suggestive of any systemic involvement. On examination, multiple, ill-defined, hyperpigmented macules with atrophy and telangiectasia were seen over the whole body with sparing of the face and sun exposed areas such as the dorsum of the hands and feet [Figure 1], [Figure 2] and [Figure 3]. A full blood cell count and biochemical studies revealed normal results. A skin biopsy specimen was taken from a patch over his right thigh which was repeated, a month later from a patch on the right side of the chest. Histopathological examination revealed the presence of atypical lymphocytes in the epidermis along with epidermotrophism, vacuolar interface dermatitis and a bottom-heavy lymphoid infiltrate in the dermis [Figure 4]. Immunohistochemistry markers were positive for CD3 and negative for CD20 markers [Figure 5] and [Figure 6].
Figure 1: Multiple ill-defined hypopigmented and hyperpigmented macules with atrophy and telengiectasia. A few discrete and many coalescing to form larger plaques seen over the chest and abdomen

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Figure 2: Multiple ill-defined hypopigmented and hyperpigmented macules with atrophy and telengiectasia seen over the back

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Figure 3: Multiple ill-defined hypopigmented and hyperpigmented macules with atrophy and telengiectasia seen over the both legs

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Figure 4: Multiple atypical lymphocytes in the epidermis and dermis with epidermotropism seen on H and E, ×10

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Figure 5: Multiple atypical haloed lymphocytes seen within the epidermis on H and E, ×40

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Figure 6: Special staining with immunohisto­chemistry markers - CD3 positive (×10)

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   References Top

1.Howard MS, Smoller BR. Mycosis fungoides: Classic disease and variant presentations. Semin Cutan Med Surg 2000;19:91-9.  Back to cited text no. 1
    
2.Mataix J, Bañuls J, Lucas A, Belinchón I, Betlloch I. Poikilodermatous mycosis fungoides. Int J Dermatol 2007;46:950-1.  Back to cited text no. 2
    
3.Farley-Loftus R, Mandal R, Latkowski JA. Poikilodermatous mycosis fungoides. Dermatol Online J 2010;16:8.  Back to cited text no. 3
    
4.Abbott RA, Sahni D, Robson A, Agar N, Whittaker S, Scarisbrick JJ. Poikilodermatous mycosis fungoides: A study of its clinicopathological, immunophenotypic, and prognostic features. J Am Acad Dermatol 2011;65:313-9.  Back to cited text no. 4
    
5.Pimpinelli N, Olsen EA, Santucci M, Vonderheid E, Haeffner AC, Stevens S, et al. Defining early mycosis fungoides. J Am Acad Dermatol 2005;53:1053-63.  Back to cited text no. 5
    
6.Nashan D, Faulhaber D, Ständer S, Luger TA, Stadler R. Mycosis fungoides: A dermatological masquerader. Br J Dermatol 2007;156:1-10 .  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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