Case Number : Case 1843 - 21 June - Dr Hafeez Diwan Posted By: Guest

I am away recording a conference in Edinburgh, Scotland the next three days so here is Hafeez Diwan's case for you to check out.

Geoff Cross - DermpathPRO Projects

This is a keloid that has been treated with steroid injection, the latter seen in the last 3 pictures

My thought was an ochronosis of the ear complicated with a steroid injection granuloma.  But maybe the eosin stain is a bit tricky for me, so agree with Raul. 

Steroid injection induced granuloma with scar formation.

Agree with Vincenzo. Collagen bundles are irregularly shaped and markedly swollen, with a brownish hue, features that favor ochronosis.

I thought of ochronosis also associated with steroid granuloma

Steroid injection granuloma. Not sure if this is genuine pigment or an artefact.

Lo completaría con Pas y Ziehl Neelsen.

It should be "right ear lesion" in the history.  Yes, this is a keloid with steroid injection (kenalog).