A nose for trouble.

A 63‑year‑old Caucasian non‑smoker presented with purplish, firm, slowly growing plaques on the nose, of 20 years duration. The bigger one involved the upper part of the nose in its entirety [Figure 1], while there were smaller ones on the left and right cheek. All the plaques were asymptomatic and did not worsen after sunlight exposure. His past medical history was unremarkable. Hematological and biochemical parameters were within normal limits. Histological examination revealed a diffuse mid‑dermal cellular infiltrate composed of neutrophils, eosinophils, plasma cells, and lymphocytes. A narrow Grenz zone was present. In the lower part of the reticular dermis, the mixed infiltrate was intermingled with a massive deposition of fascicled pattern collagen fibers and spindle cells