PMC5417814_01
Erythematopurpuric and crusted papules on the torso
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Her physical examination was within normal limits and dermatologic examination revealed tiny erythematopurpuric papules, some of which were crusted, scattered over the torso (Fig. 1).
Dense infiltrate of neoplastic cells in papillary dermis (straight arrows) with sparse epidermal infiltration (arrowheads) accompanied by extravasated erythrocytes (hematoxylin and eosin; original magnification, X400)
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The skin biopsy revealed a dense infiltrate of neoplastic cells in papillary dermis with sparse epidermal infiltration (Fig. 2).
(A) Focal immunohistochemical staining with CD1a in Langerhans cells (arrows) (immunoperoxidase; original magnification, X400). (B) Diffuse and dense positive staining with S100 protein in the Langerhans cells (arrows) (immunoperoxidase; original magnification, X400).
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In an immunhistochemical analysis, the neoplastic cells were positive for S100 and CD1a and negative for mast cell tryptase, CD117, and myeloperoxidase (Fig. 3).