PMC5485262_01
Skin punch biopsies before ((a) at 4x magnification; (b) at 10x magnification) and after ECP ((c) at 4x magnification; (d) at 10x magnification). Despite clinical improvement, interval changes in histology were not dramatic. Fibrocollagenous thickening of dermis was seen in both biopsies. In addition, dermal perivascular plasmacytic infiltrates were minimal in both biopsies.
CRIDM2017-3240287.001.jpg
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fig1
Skin punch biopsy performed at presentation was noteworthy for increased cellularity, thick and thin collagen fibers, and elastic preservation (Figures 1(a) and 1(b)). Interestingly, despite significant clinical improvement, biopsies after completion of ECP treatment did not reveal significant changes compared to biopsies prior to ECP (Figures 1(c) and 1(d)).
Disease and treatment timeline.
CRIDM2017-3240287.002.jpg
PMC5485262_01_CRIDM2017-3240287.002.jpg
fig2
The summary of the disease course is shown in Figure 2.