Cutaneous Pseudoepitheliomatous Hyperplasia from a Displaced Metallic Orthopedic Implant

Figure 2

Histopathological imaging from initial biopsy (a) and 6-month recurrence (b). Papillomatous and endophytic squamous proliferation is present with keratin plug, parakeratin, and mild pleomorphism of keratinocytes extending to the base of the biopsy (a). 6 months later, the biopsy showed overlying thickened parakeratin alternating with parakeratin with serum accumulation (b). Collections of neutrophils were also observed in the stratum corneum (b), so a PAS stain was performed to evaluate for the presence of fungal organisms. No fungal organisms were noted. The adjacent epidermis displayed acanthosis and papillomatosis composed of suprabasilar keratinocytes without significant atypia (b).