Gross examination of the incisional biopsy specimen revealed a pale white, amorphous, rubbery thickening of the dermis. Histologically, at low magnification, the specimen demonstrated a markedly thickened dermis for this anatomical site, resembling skin from the back (Figure 2). Collagen bundles in the lower reticular dermis also appeared to be thickened. They were splayed apart, with clear space between them (Figure 3). The space between the collagen bundles did not show increased mucin with colloidal iron staining. The stratum corneum and epidermis were unremarkable, and there was no inflammation.
Bilateral Symmetrical Nodules on the Feet—Diagnosis. Arch Dermatol. 2007;143(3):417-422. doi:10.1001/archderm.143.3.417-h