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Race for the Case

Race for the Case is a clinical quiz feature published quarterly in DermWorld Directions in Residency — and right here!

Answer the questions below to enter. Looking for the Winter 2020 answers? Review them now.

Spring 2021 case by Angelia Stepien, DO, and Blake Robbins, DO

A 10-month-old male with no significant past medical or family history was referred to the clinic by his pediatrician for treatment of suspected molluscum contagiosum. On physical examination, numerous 2-3 mm yellow-brown dome-shaped papules were appreciated on the head, neck, upper trunk, and genitals. An initial biopsy revealed a histiocytic infiltrate with scattered lymphocytes confined to the papillary dermis. Subsequent specimens demonstrated foamy lipidized histiocytes and giant cells with a wreath-like arrangement of nuclei. Further analyses by hematology-oncology and ophthalmology were negative for leukemia and ocular abnormalities, respectively.

Image for race for the case Spring 2021

  1. What is the primary diagnosis?

  2. What is the most common extracutaneous site of involvement?

  3. What three entities are included in the “triple association”?

  4. What is the name given to the classic multinucleate histiocyte characteristic of this condition?

  5. What are the characteristic positive and negative immunohistochemistry markers for this entity?

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