PMC6914982_01
Clinical findings of the patient. Erythema plaque with multiple brown macules, ulcer, and hyperkeratinization on the left heel.
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At the first visit, a clinical examination revealed an erythematous plaque with multiple brown macules, ulcer, and hyperkeratosis (Figure 1).
(a) Dermoscopy of the ulcer lesion. Glomerular vessels with regular arrangement in the ulcer area. (b) Dermoscopy of the erythematous plaque. There were features of intracorneal hemorrhaging.
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Dermoscopy demonstrated glomerular vessels with regular arrangement in the ulcer area (Figure 2(a)) and red-black homogeneous areas in the erythematous area (Figure 2(b)).
(a) Hyperkeratosis with thin anastomosing strands of cuboidal cells extending from the epidermis to the upper dermis (H&E stain, original magnification x 2). (b) Hematomas in the intracorneal region and upper dermis (H&E stain, original magnification x 4). (c) The cells of the ductal and cystic structures (d) were positive for CEA (original magnification x 20).
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The histopathological examination revealed hyperkeratosis and thin anastomosing strands of cuboidal cells extending from the epidermis to the upper dermis (Figure 3(a)). Hematomas were found in the intracorneal region and upper dermis (Figure 3(b)). The cells of the ductal and cystic structures were positive for carcinoembryonic antigen (CEA) (Figures 3(c) and 3(d)).