Race for the Case

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

Review the case and photos, and submit your answers to the questions below. If you answer correctly, you'll be entered to win a $25 Starbucks gift card. Free coffee and pastries are on the line — what are you waiting for?


      Fall 2018 Race for the Case

A 48-year-old white, Latin female presented to the dermatology clinic with a chief complaint of painful growing lesions on her face over the last year. A biopsy of one of the lesions showed steatocystoma. Per the patient’s request, she had received no treatment. She endorsed there was no similar affliction in the family or any recent travel; however, the patient had recently moved from Mexico a couple years prior. Her past medical history was unremarkable and review of systems was negative.  

On physical examination, she was found to have multiple yellow-pink, firm nodules and plaques distributed in the central face with overlying telangiectasia. Lymph node examination was normal.  Biopsy results of one the plaques revealed a nodular deposit of a homogeneous eosinophilic material with an associated lymphocytic and plasma cell infiltrate in the dermis.  

This case was submitted by Parin Pearl Rimtepathip, MD, PGY-2, dermatology department at Loma Linda University.


What are four histologic stains that could be used to highlight the homogeneous eosinophilic material seen on H&E?
What is the protein component in the lesion?
Name two studies that should be ordered next to evaluate for systemic involvement.
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