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Apparent Reactivation of a Fibrohistiocytic Proliferation with Features of Dermatofibroma and Dermatomyofibroma Following Systemic Immunosuppression
Author(s) -
High W.A.,
Charissi C.,
Cruz P.D.,
Ehrig T.,
Cockerell C.J.
Publication year - 2005
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.0303-6987.2005.320cq.x
Subject(s) - pathology , medicine , prednisone , cd68 , dermatofibroma , factor xiiia , biopsy , cd34 , desmin , lesion , immunohistochemistry , biology , surgery , stem cell , genetics , vimentin
A 41 year‐old man presented with an atrophic, hyperpigmented plaque on the right lower abdomen present since“birth”. He denied any prior activity at the site, and had been told it was a “scar” from a prenatal insult. Six months earlier, he developed idiopathic focal sclerosing glomerulonephritis and was placed on 70 mg prednisone per day. He had not demonstrated evidence of lupus eythematosus. Shortly after beginning this regimen, erythematous and tender papules developed around the quiescent plaque. He had tapered his prednisone dose to 60 mg per day, but additional papules continued to erupt. An ellipse biopsy was performed which included a portion of the atrophic plaque and several surrounding papules. Histological examination revealed a proliferation of fibrohistiocytes between and amongst collagen bundles. In some areas, fibrohistiocytes entrapped collagen in a fashion reminiscent of a dermatofibroma. In other areas, particularly that of the atrophic plaque, the fibrohistiocytes were less numerous and more delicate in appearance. Scattered rudimentary fascicles were demonstrated. Adnexal structures were preserved. Immunohistochemical staining revealed the fibrohistiocytes to be positive for factor XIIIa and actin, but negative for desmin, CD34, S‐100, procollagen I, and CD68. This lesion demonstrated unique clinical/histiological aspects not well characterized in the literature.