Case Number : Case 1546 - 27 May Posted By: Admin_Dermpath

?Impetigo.  ?Herpes.

I'm struggling with this lesion and finally...i don't know what it can be!

Histologically looks like a HAEM ( EM associated to Herpetic Folliculitis ) with overlapping bacterial infection, but just for chatting...

There are several multinucleated cells in last image. Although no ground glass appearance is seen, I think herpetic folliculitis is a good suggestion.

I omitted to tell you the GP had performed cryotherapy.  My report as follows:

"Severe acute inflammatory changes superficially in keeping with cryotherapy. No frank neoplasm in the multiple levels examined although a subtle actinic keratosis with mild dysplasia is a possibility."

There is demodex here of uncertain clinical significance.  I thought it would be of interest for you to see the sub-acute effects of cryotherapy (external factors) in the skin as it is something we don't see often!

Thanks Richard, nice case...something to keep in mind!