Image 1-Scaly papular rash on upper trunk.

Image 2 -Low power magnification showing a lichenoid infiltrate of Langherhans cells effacing the dermal-epidermal junction.


Image 3 -Higher power magnification showing epidermal and dermal involvement.

Image 4-Diffuse replacement of the epidermis is noted with some of the atypical cells approaching the size of the adjacent keratinocytes.

Image 5-Considerable pleomorphism is noted with some of the cells having a reniform or kidney-bean shape.

Image 6-Occasional mitotic figures are identified.

What is your diagnosis?

Case Study

This is a 3 1/2 month old boy with a one month history of a scaly papular rash on the scalp and trunk.