Case Number : Case 1783 - 29 March - Dr Hafeez Diwan Posted By: Guest

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I see some lymphocytes and plasma cells between thick and swollen collagen fibers. My first hypothesis is morphea and the second one is Lyme disease (Acrodermatitis chronica atrophicans). CPC is needed. Maybe a focus floating microscopy could help as well.

Morphea inflammatory lesion

Sincerely my first thought was of a granulomatous interstitial dermatitis, but the Colleagues are more convincing, so agree with inflammatory morphea!

Nice arrectores pilorum inflammatory infiltrate.

This is a hard case based only on microscopy but I also thought of early morphea in first place and infectious in second.

Inflammatory morphea.

Agree with Igor. Loss of pilosebaceous units with unchangeable permanence of arrector pili muscles is a clue to morphea, the idiopathic one as well as the one related to Lyme disease.