Case Number : Case 2782- 5 March 2021 Posted By: Richard Logan

posted By : vincenzo

?Pityriasis Rubra Pilaris

Posted By: Anil Patki

There's laminated hyperkeratosis, attenuated granular layer and follicular plugging with some pityrosporum spores in the follicle. PRP is a good suggestion by Vincenzo but I don't see any significant acanthosis. 

 This will need clinico-pathological correlation and the diagnosis will depend on clinical appearance of the lesions. 

 Since the lesions are pigmented, it's likely that it's acquired ichthyosis and pigmentation, both of which are paraneoplastic manifestations seen in patients with Hodgkin's lymphoma. 

 Investigations to rule out relapse of Hodgkin's may be needed in that case. 

Pigmented lesion on trunk made me think in Confluent and Reticulated Papillomatosis (CARP) 

7 hours ago, Alex-Ventura-Leon said:

Pigmented lesion on trunk made me think in Confluent and Reticulated Papillomatosis (CARP) 

Well done Alex, you are correct.  I will attach a clinical photo which shows the characteristic clinical appearance of confluent and reticulated papillomatosis seen in this case.  The histology shows the typical invagination of the epidermis by hyperkeratotic stratum corneum, and rather blunt-topped papillomatosis.  As Anil says, there are some follicular Pityrosporum yeasts but no ramifying hyphae as might be expected if this were Pityriasis versicolor.