Persistent rough skin

Presenter: Jason Wilder D.O. Debbie Palmer D.O., Cindy Hoffman D.O., Charles Gropper M.D.
Dermatology Program: St. Barnabas Hospital Dermatology Department, Bronx, New York
Program Director: Cindy Hoffman, DO, FAOCD
Submitted on: May 29, 2002

CHIEF COMPLAINT:  “I have rough skin on my neck that won’t go away.”

CLINICAL HISTORY:

Signs and symptoms:  MZ is a 52 y.o. F with a 20-year history of non-pruritic, gradually developing lesions on her left neck. The patient denies any previous treatment of these lesions.

Previous Treatment:

Other information:  Current Medication: Vioxx

PHYSICAL EXAM:

Multiple, soft, yellow papules coalescing into plaques on left neck.

 

 

LABORATORY TESTS:

Punch biopsy was performed on left neck.

Complete Blood Count WNL
Chemistry Profile WNL
Liver Function Tests WNL
Thyroid Function Tests WNL
Lipid Profile WNL
HgbA1c WNL
Erythrocyte Sedimentation Rate 10
Anti-DNA Antibody negative
Antinuclear Antibody negative
Rapid Plasma Reagin nonreactive

DERMATOHISTOPATHOLOGY:

Microscopic description: In the middle and lower thirds of the dermis, accumulations of swollen and irregularly clumped elastic fibers with calcium deposition.
An accumulation of slightly basophilic mucoid material is seen.

DIFFERENTIAL DIAGNOSIS:

1.   Xanthomatosis
2.   Cutis Laxa
3.   Ehlers-Danlos
4.   Pseudoxanthoma Elasticum
5.   Papular Mucinosis

 

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