Case Number : Case 1014 - 13th May Posted By: Guest

Scleroderma.

Yes, scleroderma.

Scleroderma

Morphea

Agree. Looks like scleroderma / morphea.

No definitive perineural/periadnexal targeting. Dermal sclerosis with non-specific, sparse, superficial and deep, perivascular lymphoplasmacytic with mildly increased mucin, no significiant increased mast cells, rare foamy histiocytes (some multinucleated). Epidermis equivocally flattened.

With that clinical hx, differential to include indeterminate leprosy or treated leprosy.
PCR may be useful to exclude mycobacteria. Fite may not be reliable.

[size=3]References:
[url="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221209/"]CLUES TO HISTOPATHOLOGICAL DIAGNOSIS OF TREATED LEPROSY[/url]
(full article link, nice images) [color=#000000][font=arial, helvetica, clean, sans-serif]Indian J Dermatol. [/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif]2011 Sep-Oct; [/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif]56[/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif](5)[/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif]: 505–509.[/font][/color]

[url="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555390/"]Morphea Simulating Paucibacillary Leprosy Clinically and Histopathologicall[/url]y
(full article link, with images) [color=#000000][font=arial, helvetica, clean, sans-serif]Indian J Dermatol. [/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif]2013 Jan-Feb; [/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif]58[/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif](1): 85.[/font][/color][/size]

Agree with morphea / scleroderma. Just like the overlying dermis, subcutaneous trabeculae are sclerotic and thickned, thus oblitering the fat lobules. A [url="https://dermpathpro.com/index.html/_/latest-news/perineural-in%EF%AC%82ammation-in-morphea-r52"]distinctive perineural inflammation[/url] is an important feature of morphea.