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Image 5-Low power magnification shows minimal histopathologic changes.

Image 6-Higher power magnification reveals a cell-poor interface dermatitis with vacuolar alteration at the dermal-epidermal junction and dyskeratotic keratinocytes.

Image 7-The reticular dermis shows separation of the collagen fibers by a diffuse increase in mucin.

What is your diagnosis?

Case Study

This is a 52 year old woman who presents with a six month history of arthritis and oral ulcerations. She now presents with a diffuse poikilodermatous rash on her trunk and extremities. (Images 1-4). Her punch biopsy revealed a cell-poor interface dermatitis with dermal mucinosis (Images 5-7).

She is ANA negative and Ro+ by serum serological studies.