History: 0804 PC Patient has had this rash on his back , face and symmetrically on areas of his limbs for 6 months. It is very itchy. It responds to strong topical steroids but never clears. A previous biopsy was reported as Jessners lymphocytic infiltrate and another as a spongiotic dermatitis. Clinically this is a deep dermal hypersensitivity reaction, annular erythema type. Possibly subacute lupus but antibody tests are negative. There was also the path suggestion of early T cell lymphoma of the skin. Two punch biopsies taken from the advancing edge.

Description: deep dermal perivascular infiltrate

Comments: Deep gyrate erythema. Tight infiltrate of lymphocytes around vessels in superficial and deep dermal plexuses. Overlying epidermis is normal.