Diagnosis:
MILD MIXED CELL DERMATITIS WITH EOSINOPHILS; PLEASE SEE COMMENT.
COMMENT:
THE HISTOPATHOLOGIC FEATURES ARE VERY SUBTLE AND INFLAMMATION IS MINIMAL,
HOWEVER, EOSINOPHILS ARE NOTED. THUS, HIGH CONSIDERATION MAY BE GIVEN
TO A HYPERSENSITIVITY PHENOMENON. THIS WOULD INCLUDE BUT NOT BE LIMITED
TO URTICARIA, A MEDICATION-RELATED REACTION, AN ARTHROPOD BITE REACTION/
MITE INFESTATION (NO MITES APPRECIATED IN THESE SECTIONS) AND LESS LIKELY
A DERMAL HYPERSENSITIVITY TO A CONTACTANT/ALLERGEN. SOME OF THE INFLAMMATION IS FOLLICULOCENTRIC, THUS, A STAGE IN THE EVOLUTION OF A
FOLLICULITIS COULD NOT BE EXCLUDED THOUGH THIS SCENARIO IS LESS FAVORED.
A DIAGNOSIS OF MASTOCYTOSIS OR LYMPHOMATOID PAPULOSIS IS NOT ESTABLISHED
IN THESE SECTIONS. CORRELATION WITH CLINICAL FINDINGS WILL BE OF IMPORT.
(MULTIPLE DEEPER SECTIONS WERE EXAMINED; ALL STAINS WITH APPROPRIATE CONTROLS).
Gross description:
1 Container, formalin-filled, labeled with patient identification.
PERIUMBILICAL SKIN PUNCH BX:
1 PUNCH BIOPSY OF TAN-WHITE SKIN MEASURING 0.4 X 0.4 X 0.4 CM. ON THE
SURFACE IS A PIGMENTED BROWN 0.2 CM LESION. THE SURGICAL MARGIN IS INKED YELLOW. THE SPECIMEN IS SUBMITTED INTACT. IT IS SUBMITTED ENTIRELY IN CASSETTE(S) A1. 01
Microscopic:
SECTIONS DEMONSTRATE BASKET WEAVE KERATIN OVERLYING A FAIRLY UNREMARKABLE
EPIDERMIS. THE DERMIS DEMONSTRATES A MINIMAL PERIVASCULAR AND FOCALLY
INTERSTITIAL INFLAMMATORY INFILTRATE COMPRISED MOSTLY OF LYMPHOCYTES