Presenter: Donna Tran, DO
Dermatology Program: Western University / College Medical Center
Program Director: Navid Nami, DO, FAOCD
Submitted on: Jan 5, 2014
CHIEF COMPLAINT: A 65-year-old gentleman presented to our dermatology clinic with complaints of hardening of his back.
Signs and symptoms: Painless, progressive hardening of his upper back present for years. He denied any associated symptoms.
Previous Treatment: Denied.
Other information: Past medical history was significant for insulin-dependent diabetes mellitus.
Physical examination revealed a symmetrical, erythematous, indurated plaque with indistinct borders involving his posterior neck and upper back (Figure 1). No restriction in range of motion of the shoulders and neck was noted.
Histopathologic examination of a punch biopsy specimen revealed an intact epidermis with no interface changes. A scant superficial perivascular lymphocytic infiltrate was present (Figure 2). A colloidal iron stain revealed an increase in dermal mucin (Figure 3).