PMC4555913_01
Single, well defined, lobulated, tumoral swelling (5 cm x 6 cm x 7 cm in size) on the left cheek. Surface of the swelling showed few pearly white flat topped papules, ulceration with hemorrhagic crust and slough. Multiple, discrete, pearly white, umbilicated papules were present over surrounding skin
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F1
On examination there was a single, well defined, lobulated, tumoral swelling 5 cm x 6 cm x 7 cm in size on the left cheek [Figure 1].
The cut surface of the excised lesion showed multiple gyri like corrugations. At the base of the excised lesion, multiple pearly white papules are seen ( )
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F2
At the base of the excised lesion, multiple pearly white papules could be seen [Figure 2].
Histopathology of the excised lesion (H and E). (a) Scanner magnification (x20) showing marked acanthosis with keratinocytes showing intracytoplasmic eosinophilic to basophilic inclusions. The epidermal ridges also extended deep into the dermis which showed dense granulomatous infiltrate along with fibrosis. The infiltrate also extended into the subcutaneous tissue with resultant septal panniculitis and extensive fibrosis. (b) Higher magnification showing marked acanthosis with intracytoplasmic eosinophilic to basophilic inclusions which are extruding out with keratinous debris (H and E, x100). (c) The dermis showed dense lymphohistiocytic infiltrate with multiple giant cells, few plasma cells/neutrophils and occasional degenerated molluscum bodies ( ) (H and E, x400). (d) Septal pannicultis with marked fibrosis (H and E)
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F3
On histopathological examination [Figure 3], there was marked acanthosis, keratinocytes showing intracytoplasmic eosinophilic to basophilic inclusions which were extruding out with keratinous debris.
Postexcision and skin grafting: Complete healing with minimal scarring
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F4
One-month later, there was complete healing at the site of skin grafting with minimal scarring [Figure 4].