PMC7154257_01
Clinical findings at the first consultation. a Vesicles and papules on the finger pads, papules on the elbow (b), and purpura on the lateral malleolus (c). d, e Histological findings of the specimen from the papules d on the finger pad of the left middle finger (HE. x100), and e on the left elbow (HE. x200). f Histological findings with immunostaining of the specimen from the left finger pad of middle finger (anti-CD163 antibody; original magnification x100). Abundance of CD163-positive cells are observed around the degenerated collagens in the dermis.
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F1
The skin eruptions expanded to all finger pads (Fig. 1a), palms, the lateral sites of the fingers, the bilateral elbows (Fig. 1b), and the lateral malleolus (Fig. 1c). Both biopsy specimens taken from the papules on the finger pad of the left middle finger and left elbow showed an infiltration of lymphocytes, histiocytes, and neutrophils with nuclear dust surrounding degenerated collagens throughout the dermis (Fig. 1d, e). Immunostaining showed an abundance of CD163- and CD68-positive cells surrounding degenerated collagens (Fig. 1f).