History:

3048lb Elderly male with onset over 4 weeks of burning and scaling on his lower lip.

Clinically this looks like actinic cheilitis with possible early scc but exclude lupus erythematosus and fixed drug eruption.

Description: Fungal hyphae and spores

Comments: Sections show a biopsy of skin in which there is a thick parakeratotic crust that contains numerous neutrophils. Abundant fungal hyphae and spores are present within the keratotic crust. The neutrophils also involve the epidermis which shows some hyperplasia and mild spongiosis. The upper dermis is infiltrated by a mild numbers of lymphocytes and occasional plasma cells. No lichenoid change is present and there is no evidence of dysplasia or malignancy. The features are those of a fungal infection.

See Neutrophils in Stratum Corneum