A 50-year-old man presented to a dermatologist complaining of bumps on his nose for the past five years. The lesions were asymptomatic and he had no other systemic complaints. His past medical history is notable for diabetes mellitus, hypercholesterolemia, hypertension, and cardiac bypass surgery. Skin examination revealed multiple fleshy nodules on and surrounding the nose. General laboratory values were within normal limits, and a systemic workup was negative for malignancy.
Histology reveals extracellular amorphous eosinophilic masses in the papillary dermis and thinning and obliteration of the rete ridges. There are diffuse deposits in the reticular dermis and subcutis with infiltration into blood vessel walls and pilosebaceous units. There was a marked infiltration of plasma cells. Image source: Dermatology Dept WUSTL What is the diagnosis? *This case is from Docplexus Editorial…
