Pruritic verrucous plaques on the buttocks

Pruritic verrucous plaques on the buttocks

IMAGES IN DERMATOLOGY Pruritic verrucous plaques on the buttocks Yang Ying, MD, Sun Jian-Fang, MD, Xu Xiu-Lian, MD, Wang Xiao-Po, MD, and Wen Si-Jia...

415KB Sizes 26 Downloads 76 Views

IMAGES

IN DERMATOLOGY

Pruritic verrucous plaques on the buttocks Yang Ying, MD, Sun Jian-Fang, MD, Xu Xiu-Lian, MD, Wang Xiao-Po, MD, and Wen Si-Jian, MD Nanjing, China

A 50-year-old man presented with a 5-year history of pruritic verrucous plaques on his buttocks. They first appeared as discrete erythematous keratotic papules and plaques involving the perianal area and gradually became confluent to form an extensive plaque. He had a history of coronary heart disease and diabetes mellitus. There were no family members who had similar manifestations. The physical examination revealed perianal brownish, hyperkeratotic, verrucous plaques with scale that were confluent and extended symmetrically onto the buttocks; around these plaques were several satellite papules and plaques (Fig 1). A biopsy specimen of the lesion was obtained and taken for histopathologic examination (Fig 2). 1.

What is the most likely diagnosis? A. B. C. D.

2.

Perianal psoriasis Lichen simplex chronicus Porokeratosis ptychotropica Disseminated superficial actinic porokeratosis

What histopathologic finding is characteristic of this disease? A. B. C. D.

Psoriasiform hyperplasia Multiple coronoid lamellae Thickened granular cell layer Coronoid lamellae at the periphery Please visit www.eblueimages.org to answer these questions.

From the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing. Funding sources: None. Conflicts of interest: None declared. Correspondence to: Sun Jian-Fang, MD, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union

Medical College, Jiangwangmiao St, No. 12, Nanjing, Jiangsu 210042, China. E-mail: [email protected]. J Am Acad Dermatol 2015;73:e43. 0190-9622/$36.00 ª 2015 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2015.03.015

e43