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Indian Journal of Dermatology
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Year : 2015  |  Volume : 60  |  Issue : 1  |  Page : 99-100
Numerous asymptomatic papulo-nodules and plaques in a young male


Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India

Date of Web Publication26-Dec-2014

Correspondence Address:
Anupam Das
"Prerana", 19 Phoolbagan, Kolkata - 700 086, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.147823

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How to cite this article:
Das D, Das A, Saha A, Sardar S, Shome K, Gharami RC. Numerous asymptomatic papulo-nodules and plaques in a young male. Indian J Dermatol 2015;60:99-100

How to cite this URL:
Das D, Das A, Saha A, Sardar S, Shome K, Gharami RC. Numerous asymptomatic papulo-nodules and plaques in a young male. Indian J Dermatol [serial online] 2015 [cited 2020 Sep 23];60:99-100. Available from: http://www.e-ijd.org/text.asp?2015/60/1/99/147823


A 16-year-old boy born of non-consanguineous marriage presented with numerous solid elevated lesions over his body. To start with, the lesions were asymptomatic flesh-colored papules over the face 1 year back and gradually, they progressed to attain the present status. Cutaneous examination revealed multiple brown-colored papules, discrete as well as confluent, yellow to brown-colored, well-circumscribed and smooth-surfaced nodules and plaques of varied sizes over face, more concentrated over the eyelids and chin, ears, neck, axillae, elbows, popliteal fossae, scrotum and oral mucosa [Figure 1], [Figure 2], [Figure 3]. Hairs, nails and teeth did not reveal any abnormality. There was no history of seizures, dysphagia, dyspnea, hoarseness of voice, blindness, increased urinary frequency, bone pain or any gastrointestinal complaints. Family history was non-contributory. Systemic examinations including ophthalmologic, oropharyngeal and otorhinolaryngological referral were done and nothing was found to be abnormal. Laboratory investigations including complete blood count, biochemistry panel, lipid profile, thyroid function tests, urinalysis, ECG, chest X-ray, and ultrasonographic studies of the abdomen were within normal limits. A skin biopsy was done from multiple sites. Histopathological examination in all the specimens showed diffuse proliferation of histiocytes, admixed with Touton giant cells, foam cells, scalloped macrophages, lymphocytes and eosinophils in the dermis [Figure 4], [Figure 5], [Figure 6]. Immunohistochemical staining for CD1a was found to be negative, whereas CD 68 and factor XIIIa were positive.
Figure 1: Multiple discrete and confluent brown-colored papules, nodules and plaques over the face and whitish papules on oral mucosa (a-c)

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Figure 2: Well-circumscribed and smooth-surfaced papulo-nodules and plaques of varied sizes on the axilla and small papules over neck and ear (a-c)

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Figure 3: Multiple discrete and confluent papulo-nodules and plaques on the upper extremity and external genitalia (a-c)

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Figure 4: Photomicrograph showing acanthosis and a dermal lesion composed of massive infiltration (H and E, ×10)

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Figure 5: Photomicrograph showing a dermal lesion composed of sheets of scalloped macrophages (arrow) and histiocytes (H and E, ×40)

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Figure 6: Photomicrograph showing foam cells (arrow a), Touton giant cells (arrow b), lymphocytes and eosinophils (H and E, ×40)

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Question

What is the diagnosis?



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   References Top

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Eisendle K, Linder D, Ratzinger G, Zelger B, Philipp W, Piza H, et al. Infammation and lipid accumulation in xanthoma disseminatum: Therapeutic considerations. J Am Acad Dermatol 2008;58 Suppl 2:S47‑9.  Back to cited text no. 6
    
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