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SKINDIA QUIZ
Year : 2017  |  Volume : 8  |  Issue : 2  |  Page : 157-158  

SkIndia quiz 36: A phantasmagoric lesion: A face for thought


Department of Dermatology, Venereology and Leprosy, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Date of Web Publication16-Mar-2017

Correspondence Address:
Sunil K Gupta
Department of Dermatology, Venereology and Leprosy, Dayanand Medical College and Hospital, Ludhiana - 141 001, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.202283

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How to cite this article:
Gupta SK, Sethi A. SkIndia quiz 36: A phantasmagoric lesion: A face for thought. Indian Dermatol Online J 2017;8:157-8

How to cite this URL:
Gupta SK, Sethi A. SkIndia quiz 36: A phantasmagoric lesion: A face for thought. Indian Dermatol Online J [serial online] 2017 [cited 2017 Nov 20];8:157-8. Available from: http://www.idoj.in/text.asp?2017/8/2/157/202283

A 22-year-old immunocompetent female presented to the dermatology outpatient department with a hyperkeratotic erythematous plaque with irregular border over the malar area of face and bridge of nose since one year. Initially, the lesion started as papule on the right cheek, which eventually extended onto the bridge of the nose and further over the malar regions of the left cheek to attain the present size, developing pus discharge at places and crusting and scarring at other places [Figure 1]. It was tender on examination. There was no history of fever, photosensitivity, visit outside the native place, or any chronic illness. Family history was nonsignificant. The patient had taken treatment in the form of oral antibiotics, oral steroids, and intralesional steroid injection but with no relief. Hematological and biochemical parameters were within normal limits. Histopathological examination from the left malar area revealed area of ulceration with dense inflammatory infiltrate, acute and chronic, rich in plasma cells. On step sectioning, a solitary epithelioid cell granuloma with Langhans giant cells was seen. However, there was no caseation necrosis [Figure 2] and [Figure 3], H and E, ×40].
Figure 1: Hyperkeratotic erythematous plaque with irregular borders over the malar area of face with scarring at places

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Figure 2: Dense inflammatory infiltrate, acute and chronic, rich in plasma cells (H and E, ×40)

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Figure 3: Langhans giant cells seen on step sectioning without caseation necrosis (H and E, ×40)

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Special stain: Ziehl–Neelsen stain for acid fast bacilli, Grocott-Gomori's (or Gömöri) Methenamine Silver stain and Periodic Acid Shiff stain for fungus, and Giemsa stain for Leishman Donovan bodies were negative.



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Marcoval J, Srvitje O, Moreno A, Jucglà A, Peyrí J. Lupus vulgaris: Clinical, histopathologic, and bacteriologic study of 10 cases. J Am Acad Dermatol 1992;26:404-7.  Back to cited text no. 2
    
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Yates VM. Mycobacterial infection. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. Oxford: Blackwell Science Ltd; 2010. p. 31.16-9.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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