PMC8463211_01
Clinical photograph showing multiple nodules on the patient's forehead.
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fig1
All lesions looked identical and described as moderately painful pink violaceous papules and nodules with irregular borders (Figure 1).
Micrograph of the forehead lesions demonstrating intense dermal-based infiltrate of foamy macrophages with sparing of skin adnexa. H&E x40.
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fig2
Histologic evaluation of the recurrent/persistent lesions revealed an intense dermal infiltrate of foamy tissue macrophages with a minor admixture of plasma cells, lymphocytes, and scattered multinucleated giant cells (see Figures 2 and 3).
Higher-power view revealed predominantly foamy tissue macrophages with a minor admixture of plasma cells, lymphocytes, and scattered multinucleated giant cells. H&E x100.
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fig3
Histologic evaluation of the recurrent/persistent lesions revealed an intense dermal infiltrate of foamy tissue macrophages with a minor admixture of plasma cells, lymphocytes, and scattered multinucleated giant cells (see Figures 2 and 3).
A close up of a different field shows a predominance of spindled cells with prominent extracellular collagen deposition.
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fig4
Other areas showed a predominance of spindled cells and associated extracellular collagen fibers (see Figure 4).
CD163 immunohistochemical study highlights the tissue macrophages. x100 magnification.
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fig5
The lesional cells were positive for CD163 (see Figure 5) and CD68 and negative for CD1a, thus confirming them to be of mononuclear-macrophage lineage.