Case Number : Case 2078 - 24 May 2018 Posted By: Iskander H. Chaudhry

Chillblain or lymphoid hyperplasia

CD31?HHV8?  Angiosarcoma is my first thought. 

Superficial and deep dense perivascular and periadnexal infiltrate of lymphocytes and ?  mucin in upper dermis. I think this is lupus tumidus. Cutaneous lymphoid hyperplasia is the second possibility which can be ruled out by clinical correlation.

I'm better watching this case on my computer, and agree with Anil comment. 

I would favour Jessner's which some regards as a variant of lupus. I am assuming the infiltrate is mainly T-cells of course (if not would have to re-consider).

Dear all,

Some good guesses here so I've included full observations/diagnosis below:

In the dermis there is a superficial and deep, light perivascular and to a lesser extent periadnexal chronic inflammatory cell infiltrate. Basement membrane thickening and mucin deposition are not appreciable (DPAS negative). There are no fungal hyphae on special stains. The main histological differentials are Jessner's lymphocytic infiltration of skin, tumid lupus erythematosus, lymphocytoma cutis, and polymorphous light eruption.
The features are those of a superifical and deep perivsacular dermatitis; and in the right clinical context are in keeping with Jessner's lymphocytic infiltration of skin.

Dr Iskander Chaudhry