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A. S. Alkali, N. J. E. Wilson, N. Leonard, An asymptomatic eruption on the arms, Clinical and Experimental Dermatology, Volume 33, Issue 5, 1 September 2008, Pages 675–676, https://doi.org/10.1111/j.1365-2230.2008.02812.x
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Conflict of interest: none declared.
Clinical findings
A 44‐year‐old woman presented with a 6‐month history of slowly progressive asymptomatic lesions on the arms. They initially appeared on the dorsa of the hands and spread to the forearms. She was otherwise well. On examination, multiple flesh‐coloured, dermal papules measuring approximately 3 mm in diameter were noted on the extensor aspects of both hands and forearms (Fig. 1). The rest of the skin was normal.
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Histopathological findings
A diagnostic biopsy was taken from one of the papules. Sections were stained with haematoxylin and eosin, and with alcian blue pH 2.5. Under low magnification, a normal epidermis overlying wide dermal spaces between collagen fibres was seen (Fig. 2a). Increased dermal mucin was noted, with no associated increase in fibroblast numbers. Alcian blue staining showed well‐circumscribed changes in the upper and mid reticular dermis, with a small Grenz zone (Fig. 2b). Results of routine blood tests including full blood count, erythrocyte sedimentation rate, liver function tests, urea and electrolytes, serum lipids, thyroid function tests, serum complement, immunoglobulins, serum protein electrophoresis, immunoelectropheresis, and autoantibodies were normal or negative.
