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Off-Center Fold
July 2012

Nonhealing Ulcer of the Left Fifth Finger—Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2012;148(7):850. doi:10.1001/archderm.148.7.850-c
Microscopic findings and clinical course

The biopsy specimens showed a densely cellular, nodular proliferation of atypical epithelioid and spindle-shaped cells with eosinophilic cytoplasm. There was also central necrosis with peripheral palisading of tumor cells. Immunohistochemical studies identified tumor cells that expressed pan-cytokeratin, vimentin, and epithelial membrane antigen but failed to express S-100 protein, HMB-45, and CD31. A computed tomographic scan of the chest, abdomen, and pelvis revealed no signs of metastatic disease. The patient underwent ray amputation with sentinel lymph node biopsy. Given the lack of identifiable metastases, the patient decided to not undergo chemotherapy.

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