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SKINDIA QUIZ
Year : 2016  |  Volume : 7  |  Issue : 6  |  Page : 558-560  

SkIndia Quiz 31: Erythematous plaque over the chin


Department of Dermatology, SVS Medical College, Yenugonda, Mahbubnagar, Telangana, India

Date of Web Publication11-Nov-2016

Correspondence Address:
Angoori Gnaneshwar Rao
F12, B 8, HIG-2 APHB Baghlingampally, Hyderabad - 500 044, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.190561

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How to cite this article:
Rao AG. SkIndia Quiz 31: Erythematous plaque over the chin. Indian Dermatol Online J 2016;7:558-60

How to cite this URL:
Rao AG. SkIndia Quiz 31: Erythematous plaque over the chin. Indian Dermatol Online J [serial online] 2016 [cited 2019 Jul 16];7:558-60. Available from: http://www.idoj.in/text.asp?2016/7/6/558/190561

A 35-year-old female presented with an asymptomatic, erythematous plaque over the chin since five months. There was no history of cough, weight loss, fever or sensory deficit. Cutaneous examination revealed a well-defined, oval erythematous plaque on left side of chin 2 cm × 1.5 cm in size with a depression in the center of chin [Figure 1]. Sensations were intact and there was neither nerve thickening nor tenderness. Diascopy revealed apple jelly nodules. Routine blood investigations were normal except for raised erythrocyte sedimentation rate (90 mm in first hour). Mantoux test was strongly positive (18 mm × 16 mm). Chest skiagram and ultrasonography of the abdomen were normal. Serum calcium, angiotensin converting enzyme and serum globulins were normal. Slit skin smear taken from the plaque for acid fast bacilli was negative. Lesional tissue for culture on Lowenstein-Jensen's medium and for mycobacterial DNA was negative. Skin biopsy showed epidermal atrophy and dermis showed multiple granulomas containing lymphocytes, histiocytes and epitheloid cells along with a few Langhan's type of multinucleated giant cells [Figure 2],[Figure 3],[Figure 4] and intact reticulin network [Figure 5]. No caseation was seen. Fite-Faraco stain for acid fast bacilli was negative.
Figure 1: Well defined, oval and erythematous plaque on the left side of chin with depression of chin

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Figure 2: Histopathology scanner view with H and E stain showing atrophy of the epidermis. Dermis shows multiple granulomas

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Figure 3: Histopathology ×10 H and E stain. Showing atrophy of epidermis. Dermis shows multiple granulomas containing lymphocytes, histiocytes and epitheloid cells along with few Langhan's type of multinucleated giant cells

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Figure 4: Histopathology ×40 H and E stain showing Langhans giant cell in the epitheloid cell granuloma with surrounding lymphocytes

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Figure 5: Histopathology ×40 showing reticulin fibers around the granulomas

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   Question Top


What is your diagnosis?



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   References Top

1.
Reddy RR, Shashi Kumar BM, Harish MR. Cutaneous sarcoidosis – A great masquerader: a report of three interesting cases. Indian J Dermatol 2011;56:568-72.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Fujii K, Okamoto H, Onuki M, Horio T. Recurrent follicular and lichenoid papules of sarcoidosis. Eur J Dermatol 2000;10:303-5.  Back to cited text no. 2
    
3.
Callen JP. Sarcoidosis. In: Callen JP, Jorizzo JL, Greer KE, Penneys NS, Piette WW, Zone JJ, editors. Dermatological Signs of Internal Disease. Philadelphia: WB Saunders Co.; 1995. p. 293-300.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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