PMC10408662_01
Clinical appearance of the skin lesion. (A) Scattered erythema and infiltrative plaques on the head, isolated and not fused. (B and C) Numerous papules and nodules on the patient's trunk and limbs, with well-demarcated.
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On physical examination, the patient was noted to have scattered 2.0-4.0-cm reddish or dark erythema and infiltrative plaques on the head, isolated and not fused (Figure 1A). The trunk and limbs had numerous soybean bean- to broad-sized papules and nodules, which were well-demarcated, without fusion, and indurated (Figure 1B and C).
Histological findings of plaque on the head. (A and B) Prominent plasma cell infiltration of the dermis (HE, x400).
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Many plasma cells, histiocytes, lymphocytes, and eosinophils were infiltrated in the dermis in sheets or focal, showing small neutrophilic abscesses (Figure 2A and B).
Immunohistochemistry results. (A-L) Infiltrating plasmacytes were CD3, CD4, CD20, CD8, CD68, CD163, CD138, Ki-67, Kappa, Lambda, IgG and IgG4 positive (x200).
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Polyclonal nature was confirmed by positive staining for both kappa and lambda chains (Figure 3).
Clinical appearance after 6 months of treatment.
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After 6 months of treatment, the skin lesions were dramatically diminished (Figure 4).