A peculiar dermatomal plaque.

Approximately 25% of the inflammatory infiltrate showed CD23 SP + sp immunostaining, consistent with the patient's underlying diagnosis of CLL. HZ granulomatous dermatitis in this case should be differentiated from acute HZ infection. Although acute HZ may show a lymphoplasmacytic infiltrate, multinucleated giant cells are more characteristic of a late granulomatous reaction, which favors a diagnosis of HZ granulomatous dermatitis.[1] However, it should be noted that acute HZ shares some histologic features with HZ granulomatous dermatitis and that granulomatous changes can appear in acute HZ presentations within 6 weeks of onset.[1]. [Extracted from the article]