PMC5838761_01
(a-c) Hyperpigmented, indurated plaques with marked hypertrichosis arranged symmetrically over medial aspect of thighs and legs, (d) hyperpigmented hypertrichotic indurated plaques over lower back and sacral area
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F1
On mucocutaneous examination well defined, bilaterally symmetrical hyperpigmented, indurated plaques with marked hypertrichosis were present over medial aspect of thighs and legs [Figure 1a-c]. Similar lesions were present over sacral area and lower back bilaterally [Figure 1d].
Hallux valgus deformity of both great toes seen
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F2
Hallux valgus was also present [Figure 2].
(a) Mild irregular acanthosis, increased melanin deposition in basal keratinocytes with thickened collagen bundles in upper and mid dermis and perivascular infiltrate of histiocytes (H and E, x10), (b) CD45 positivity in lesional cells; (c) CD68 positivity in dermal perivascular histiocytic infiltrate, (d) CD34 positivity in immunohistochemistry in dendritic cells
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F3
Immunohistochemistry was positive for CD68 and CD45 in dermal perivascular histiocytic infiltrate and for CD34+ in vessel endothelium [Figure 3].