The punch biopsy specimen showed pseudoepitheliomatous hyperplasia with intraepidermal microabscesses. A few follicular infundibula appeared enlarged and contained inflammatory debris and neutrophils. Microabscesses surrounded by a narrow palisade of histiocytes were seen in the superficial dermis. Scattered plasma cells, lymphocytes, and occasional eosinophils were also present. The deep dermis and subcutis were spared. No microorganisms were identified on Fite, Gomori methenamine-silver, or tissue Gram stains. No bacteria, acid-fast bacilli, or fungi were isolated from 3 consecutive sets of tissue cultures.
Verrucous Annular Ulcerated Hip Plaques. Arch Dermatol. 2000;136(10):1263-1268. doi: