PMC5651126_01
Clinical examination found multiple scalp erosions and crusted plaques.
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The rest of the scalp was covered with erosions and crusted plaques (Figure 1).
Excision revealed a variably atrophic epidermis with an impressive horn-like crust containing neutrophilic debris (H-E 2x).
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Excision revealed a variably atrophic epidermis with an impressive crust containing neutrophilic debris (Figure 2).
In areas, the material was revealed to have birefringent filamentous areas and a crystalline appearance (H-E 20x).
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High power examination of the horn-like crust revealed numerous neutrophils, bacterial (coccal) colonies, and strikingly pale eosinophilic material (Figure 3). On close examination, this material was revealed to have birefringent filamentous areas and a crystalline appearance (Figure 3).
Neutrophils infiltrate the superficial layers of the epidermis. The dermis showed a mixed chronic inflammatory response and some dermal fibrosis.
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The dermis showed a mixed chronic inflammatory response and some dermal fibrosis (Figure 4).