The biopsy specimen revealed a dense nodular or diffuse cell infiltrate throughout the dermis and subcutaneous tissue. Small lymphocytes predominated, admixed with epithelioid tubercles and giant cells. Single, slightly atypical lymphocytes were seen within the epidermis. Elastolysis was observed on Weigert–van Gieson staining. Immunostaining was positive for leukocyte common antigen, CD3, and CD4.
The diagnosis of granulomatous slack skin was established, and the patient underwent further evaluation. Bone marrow aspiration showed no neoplastic infiltrate. The results of a serologic test for human T-lymphotropic virus 1 and a Sézary cell count were negative. Abdominal ultrasound showed a thickening of the abdominal wall where an indurated plaque was present, but no visceral enlargement. There was no evidence of disease spread beyond the skin.
Lax Skin Masses in a 47-Year-Old Woman—Diagnosis. Arch Dermatol. 2005;141(12):1595. doi:10.1001/archderm.141.12.1595-e