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Quiz
2015:81:1;93-94
doi: 10.4103/0378-6323.148604
PMID: 25566920

A nose for trouble

Giuseppe Fumo, Federico Patta, Carla Milo, Luca Pilloni, Laura Atzori
 Department of Dermatology, University of Cagliari, Italy

Correspondence Address:
Federico Patta
Department of Dermatology, University of Cagliari
Italy
How to cite this article:
Fumo G, Patta F, Milo C, Pilloni L, Atzori L. A nose for trouble. Indian J Dermatol Venereol Leprol 2015;81:93-94
Copyright: (C)2015 Indian Journal of Dermatology, Venereology, and Leprology

A 63-year-old Caucasian non-smoker presented with purplish, firm, slowly growing plaques on the nose, of 20 years duration. The bigger one involved the upper part of the nose in its entirety [Figure - 1], while there were smaller ones on the left and right cheek. All the plaques were asymptomatic and did not worsen after sunlight exposure. His past medical history was unremarkable. Hematological and biochemical parameters were within normal limits. Histological examination revealed a diffuse mid-dermal cellular infiltrate composed of neutrophils, eosinophils, plasma cells, and lymphocytes. A narrow Grenz zone was present. In the lower part of the reticular dermis, the mixed infiltrate was intermingled with a massive deposition of fascicled pattern collagen fibers and spindle cells [[Figure - 2] and [Figure - 3]].

Figure 1: Erythematous indurated plaque of the upper nose
Figure 2: A narrow Grenz zone and superficial and deep inflitrates are noted. (H and E, ×4)
Figure 3: The infiltrate shows many eosinophils along with neutrophils, lymphocytes and plasma cells. Fascicles of spindle cells are also seen. (H and E, ×40)

What Is Your Diagnosis ?



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