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January 2008

Multiple Erythematous Eroded Patches and Papules on the Scalp—Diagnosis

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Arch Dermatol. 2008;144(1):105-110. doi:10.1001/archdermatol.2007.11-b

Histopathologic examination of the punch biopsy specimen showed a dense mononuclear cell infiltrate in the superficial dermis, composed of histiocytes with kidney-shaped nuclei, lymphocytes, and eosinophils. The histiocytes were positive for S100 protein and CD1a. Radiologic imaging studies demonstrated multiple small lytic lesions in the skull and mild degenerative changes in the thoracic and lumbar spine. Magnetic resonance imaging of the brain and pituitary suggested enhancement and nodularity of the infundibulum with mild enhancement of the hypothalamus. A computed tomographic scan of the abdomen did not show any hepatosplenomegaly.