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A reappraisal of the histologic findings of pigmented pretibial patches of diabetes mellitus
Author(s) -
Houck Gregory M.,
Morgan Michael B.
Publication year - 2004
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2004.00133.x
Subject(s) - hemosiderin , microangiopathy , pathology , medicine , hyaline , plexus , diabetes mellitus , pathogenesis , context (archaeology) , anatomy , biology , endocrinology , paleontology
Background: Pigmented pretibial patches (PPPs) are the most common cutaneous alterations in diabetes mellitus, found in up to 50% of diabetic patients. They classically present as flat‐topped, dull‐red papules on the pretibial areas, later becoming hyperpigmented and atrophic. Little is known regarding the pathogenesis of these lesions, and the histopathologic findings have been regarded as non‐specific. Methods: We investigated the clinical and pathologic attributes of a series of 12 diabetic patients with PPP in an effort to discern any specific histologic attributes compared to normal skin removed from diabetic patients with cutaneous carcinoma. Results: All cases of PPP showed hyaline microangiopathy, all patients showed extravasated erythrocytes and/or hemosiderin deposits, and 10 patients showed an appreciable number of perivascular plasma cells. The average number of plasma cells per vascular plexus was 2.2. Control specimens removed from five diabetic patients showed hyaline microangiopathy, and three showed extravasated erythrocytes and hemosiderin. One patient showed a single vascular plexus with two plasma cells, p = 0.01. Conclusion: The presence of increased dermal perivascular plasma cells in the appropriate clinical context might be an important and under‐recognized clue for PPP. The pathogenic significance of this finding is unknown.