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March-April 2013

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History: 49 yo WM with a 20+ year history of a plaque-like rashing on the face which has been slowly progressive (Figure 1 and 2). The lesions are periodically tender to the touch, but otherwise asymptomatic.  Prior treatment included intralesional triamcinolone, cryotherapy, desoximetasone 0.25% gel and intense pulse light (IPL).

 

Past Medical and Family History: Negative

 

Allergies: Negative

 

Physical Exam: 2mm – 20 mm red-brown papules and plaques with telangectasia were present on the forehead, nose and cheeks.

 

Histopathology: A dense mixed cellular infiltrate filled the mid-dermis. A narrow Grenz Zone separated the inflammation from  an unremarkable epidermis  (figure 3 and 4).

 

 

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