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March> 1, 2008

An Unusual Keratotic Papular Eruption—Diagnosis

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Arch Dermatol. 2008;144(3):405-410. doi:10.1001/archderm.144.3.dof70020-h

Histopathologic features showed acanthosis of the epidermis and the infundibular portion of hair follicles in association with hyperkeratosis and focal parakeratosis and scattered apoptotic keratinocytes in the stratum spinosum. A lichenoid tissue reaction was noted at the dermoepidermal junction composed of lymphocytes, histiocytes, and very occasional plasma cells with numerous colloid bodies. The infiltrate occupied the papillary dermis and also extended into the reticular dermis in a perivascular distribution. No syringocentricity was noted. A striking feature was the presence of massive telangiectasias in the papillary dermis.