Image 1-Reticulated rash on chest.


Image 2 -Low power magnification shows a superficial and deep, perivascular and periadnexal lymphocytic infiltrate.

Image 3-The infiltate is focally dense around hair follicles.

Image 4-The deeper reticular dermis shows an accentuated perivascular infiltrate.

Image 5-Highest power magnification of the deep reticular dermis shows the thick collagen bundles separated by wispy basophilic staining material.

Image 6-Colloidal iron stain stains the intercellular stromal material blue.

What is your diagnosis?

Case Study

This is a 28 year old woman who presents with a reticulated rash on her chest. She has been on topical and oral steroids without resolution. Doxycyline seemed to make it worse. The area is photosensitive and has been present for 1 year without resolution and without new lesions.