The hematoxylin-eosin–stained sections showed a normal epidermis and a dermis demonstrating some splitting of collagen bundles, with a mild perivascular infiltrate and scattered stellate fibroblasts. The Alcian blue stain revealed prominent mucin deposition between collagen bundles.
The patient was evaluated by the hematology/oncology service and thought to have a monoclonal gammopathy of undetermined significance, and no therapy was given. She has had slight improvement with intralesional steroid injections and betamethasone dipropionate (Diprosone) ointment twice a day.
Lichenoid Papules on the Hands, Arms, and Ear of an 84-Year-Old Woman. Arch Dermatol. 2001;137(2):219-224. doi: