PMC522804_01
Lichenoid papules beside thickened skin on the dorsal aspect of the left shoulder.
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F1
Caucasian woman who initially presented in 2003 with a multitude of progressive lichenoid 2-4 mm papules starting two years ago, particularly marked on the forehead right above both eyebrows, on the dorsal aspects of the forearms, shoulders, legs as well as on the gluteal region, accompanied by severe pruritus (Fig. 1). Clinically, the papules were judged as discrete, circumscribed, erythematous to skin-coloured, firm skin eruptions associated with an induration and stiffening of the affected lesions.
Immunhistochemistry unveiling sporadic lymphocytes beside a high number of anti-mastcell-tryptase+ cells within the subepithelial perivascular infiltrate.
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F2
In brief, immunolabelling revealed occasional perivascular CD4+ and CD20+ lymphocytes located in the papillary dermis and a high number of anti-mastcell-tryptase+ cells within the subepithelial perivascular infiltrate revealing a continuing decrease with increasing depth (Fig. 2).
Mucinous deposition of the upper and mid-dermis accompanied by an elevated occurrence of MIB-1+ dermal fibroblasts.
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F3
Simultaneously, an increased dermal expression of MIB-1+ cells (Fig. 3), morphologically predominantly fibroblasts, within the upper and mid dermis and sporadic FGF-R+ cells in an unspecific distribution could be detected.