PMC5288298_01
Giant variant of acquired perforating dermatosis. A, Photograph from clinical examination shows a generalized eruption. B, Note the annular plaques with a central crater or an eschar.
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On physical examination, the patient had various sized, annular plaques with sharply demarcated pink-to-violaceous borders:some with a central crater and some with a central eschar on her trunk and extremities (Fig 1, A and B).
A, Marked degeneration of elastic fibers in the superficial dermis and transepidermal elimination through a hyperplastic epidermis. B, Higher magnification of degenerated hypereosinophilic elastic fibers. (A and B, Hematoxylin-eosin stain.)
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Histopathologic examination from a characteristic lesion found markedly degenerative elastic fibers in the superficial dermis with a striking pattern of transepithelial elimination through the epidermis and into the stratum corneum along with evidence of trauma characterized by a superficial myofibroblastic response of collagen deposition (Fig 2, A and B).