Routine hematoxylin-eosin staining of the biopsy specimen revealed some spongiosis of the epidermis. The upper dermis was edematous. There was a dense perivascular and interstitial infiltrate of the mature neutrophils in the superficial and midreticular dermis. Blood vessels were uninvolved. A Frazier-Lendrum stain for fibrin was performed and revealed no fibrin deposition within dermal blood vessels.
One week after the biopsy, the patient's skin lesions had almost completely cleared and her fever and tibial pain had resolved. Treatment with prednisolone was planned, but because of the patient's improvement no therapy was instituted. There was no evidence of an underlying process.
Annular Erythematous Plaques and Tibial Pain in a Child. Arch Dermatol. 1998;134(5):625-630. doi: