Purpura pigmentosa progressiva. incident light microscopy, blurred, yellow-brownish spots (star), in addition to punctiform, fresh bleeding (horizontal arrow) also older brown-reddish spots already in decomposition (vertical arrow). line pattern: traced skin line pattern of the skin of the lower leg
Fasciitis, necrotizing. foot of a 53-year-old patient. after a banal traumatic injury to the inner ankle, a fulminant, highly painful, doughy swelling developed within 3 days with diffuse redness of the entire lower leg. extensive necrosis of the skin of the inner ankle and over the edge of the tibia. fluctuating swelling in the middle of the lower leg. here incision with evacuation of about 50 ml of purulent secretion.
erythema induratum. solitary, chronically stationary, 4.0 x 3.0 cm in size, only imperceptibly growing, firm, moderately painful, reddish-brown, flatly raised, rough, scaly nodules with a deep-seated part (iceberg phenomenon). intermediate painful ulcer formation (Fig). no evidence of mycobacteriosis.
Erythema chronicum migrans: about 2-3 months old with slow peripheral expansion; painless, non-itching, circular erythema which is well distinguishable from normal skin; the bite is still centrally visible.
Cellulitis eosinophil: acute formation of circumscribed, large, sharply margined plaques The surface of the plaques may have an orange peel-like texture (see following figure)
Acrodermatitis chronica atrophicans: Initially flat, oedematous, livid red plaques; beginning transition to pronounced, flaccid atrophy with typical wrinkling of the skin (cigarette-paper phenomenon) and clearly translucent vein networks.
Malum perforans: Sharply defined, sparsely documented ulcer in the area of the sole of the foot in the presence of polyneuropathy and microangiopathy in long-term known diabetes mellitus.
Lichen planus exanthematicus: since 2 months persistent, itchy, generalized, dense rash with emphasis on trunk and extremities (face not affected). here formation of large reddish PLaques. in the marginal area the plaques dissolve into papules. the typical shine of the Lichen planus efflorescence is very well visible.
Primary cutaneous marginal zone lymphoma: localized red (surface smooth) plaque with circulatory margins, known for several months and only moderately consistent, no evidence of systemic involvement.
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