PMC9085217_01
PMC9085217_02
Physical examination revealed dusky indurated plaques on the central and lower face (a) and arms (b) with associated oedema.
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F1
On physical examination of the new skin changes, there were dusky areas of induration involving the central and lower face, bilateral forearms, and extending onto her hands with associated oedema (Figure 1).
PMC9085217_03
Histological examination: Incisional biopsy from the right upper arm [haematoxylin and eosin (H&E) staining] showing (a) 20x magnification: vasculitis and fibrinoid necrosis and (b) 10x magnification: deep subcutaneous infiltrate with oedema and karyorrhexis.
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F2
An incisional biopsy revealed a predominantly lymphocytic, nodular, perivascular, and periadnexal inflammatory infiltrate in the deep dermis and subcutis, with associated oedema, fat necrosis, and karyorrhexis in the subcutaneous fat, confirming a panniculitis (Figure 2).
PMC9085217_04
Timeline with the most relevant data of the clinical case.
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F3
A timeline of events is shown in Figure 3.