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SkinIndia Quiz 53: A dusky red plaque with satellite lesions

1 Department of Dermatology, Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
2 Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

Correspondence Address:
Arun C Inamadar,
Department of Dermatology, Venereology and Leprosy, Shri B M Patil Medical College, Hospital and Research Center, BLDE (Deemed to be) University, Vijayapur - 586 103, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_152_18

How to cite this URL:
Adya KA, Inamadar AC, Palit A, Janagond AB. SkinIndia Quiz 53: A dusky red plaque with satellite lesions. Indian Dermatol Online J [Epub ahead of print] [cited 2019 Jul 21]. Available from: http://www.idoj.in/preprintarticle.asp?id=261824

A 27-year-old man presented with a dark colored lesion on the left upper back since 6 years. It began as a small, dark red papule that increased in size over time. Patient also complained of episodic excessive sweating over the lesion. Examination revealed a hyperpigmented irregular plaque with a dusky-red hue measuring about 5 × 8 cm with geographical margins and smaller satellite lesions involving the left scapular region [Figure 1]. Histological examination of the lesion revealed multiple circumscribed lobules and aggregates of elongated and spindle-shaped cells throughout the dermis that demonstrated luminal differentiation at the center and at the margins [Figure 2]. The lumina were lined by large endothelial cells [Figure 3]. The overlying epidermis was mildly hyperplastic with irregular elongation of rete ridges and increased melanization of the basal layer.
Figure 1: Irregular dusky red plaque with geographic margins and multiple satellite lesions on the left scapular region

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Figure 2: Multiple discrete lobules of cells with slit-like lumina in the center and at the margins are noted in the entire dermis (H and E, ×5)

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Figure 3: Higher magnification of an individual cellular lobule shows elongated and spindle-shaped cells with central and marginal luminal differentiation that are lined by large atypical endothelial cells (H and E, ×40)

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  [Figure 1], [Figure 2], [Figure 3]


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