PMC6297267_01
Slowly growing solitary asymptomatic verrucous plaque on the back of the hand of a 2-year-old girl.
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On physical examination, a 4-cm, erythematous, infiltrated plaque covered by a thick whitish scale was present (Fig 1).
Photomicrograph of a skin biopsy specimen from the left hand at presentation shows epidermal hyperplasia and a prominent infiltrate of atypical, small-to-medium size lymphocytes, diffuse epidermotropism, and necrotic keratinocytes. (Hematoxylin-eosin stain.)
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Histopathology found epidermal hyperplasia and a prominent infiltrate of atypical, small-to-medium size lymphocytes showing diffuse epidermotropism (Fig 2).
Immunohistochemical studies showed CD8 predominance of the epidermotropic lymphocytes.
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Immunohistochemical studies showed diffuse reactivity for CD3, CD8 (Fig 3), and TIA-1; CD4 labelling was less intense and confined to the dermal lymphocytes.