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Nazzaro G., Coggi A., Gianotti R.
Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italia
A 57-year-old Caucasian man presented with a 1-month history of an asymptomatic nodule on his neck, associated to regional lymphadenopathy. His medical history included an HIV infection with high viral load and low CD4 levels. Clinical differential diagnoses were ulcerated dermatofibroma, syphiloma, pseudolymphoma or adnexal neoplasia. The lesion was surgically removed and histopathological examination with immunohistochemical staining were performed. Hematoxylin-eosin stain at low magnification showed erosion of the epidermis and an inflammatory infiltrate that, at higher magnification, was composed of lymphocytes, eosinophils and scattered blasts. Step sections revealed the typical eosinophilic intracytoplasmic inclusions of keratinocytes (Henderson-Patterson bodies). Our case was atypical because of the clinical appearance, i.e. uniqueness of the lesion and association with regional lymphoadenopathy, and because of histology, i.e. preponderance of CD30+ reactive infiltrate.