PMC3746225_01
(a and b) 2 cm sized erythematous semi-transparent bullae with a white nodule inside
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F1
On examination, single 2 cm sized erythematous semi-transparent bullae with a white nodule was seen on the medial aspect of the right upper arm [Figure 1a and b].
Photograph of a bouncy ball
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F2
The appearance of this resembled a bouncy ball [Figure 2].
Gross specimen of excised material
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F3
Routine investigations were normal and excision biopsy was carried out [Figure 3].
Histopathological features of excision biopsy showing islands of basaloid cells with central abrupt keratinization, shadow (ghost) cells, and dilated lymphatics with dermal edema (H and E, x10)
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F4
Histopathology revealed islands of basaloid cells with central abrupt keratinization and dilated lymphatics with dermal edema [Figures 4 and 5a].
(a) Basaloid cells undergoing abrupt keratinization; (b) Ghost cells/shadow cells; (c) Foreign body giant cell reaction; (d) Small foci of calcification (H and E, x40)
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F5
Histopathology revealed islands of basaloid cells with central abrupt keratinization and dilated lymphatics with dermal edema [Figures 4 and 5a]. Ghost cells (shadow cells) [Figure 5b], foreign body giant cell reaction [Figure 5c], and small foci of calcification were also seen [Figure 5d].