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A 58-year-old woman with a medical history significant for sarcoidosis, type 2 diabetes, and hyperlipidemia is evaluated for a 9-month history of bilateral pruritic, xerotic, hyperpigmented patches on her face. She reports trying her bleaching creams to treat the lesions, which initially moderately lighten the skin, but the lesions then recur and enlarge.
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What is most likely to be revealed on histology?
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A. Deeply pigmented dendritic melanocytes with dissecting bundles of dermal collagen
B. Hyperkeratosis, irregular acanthosis, and keratinous invaginations of the epidermis.
C. Ochre-colored, banana-shaped fibers in the dermis
D. Orthokeratotic hyperkeratosis and papillomatosis of stratum spinosum
E. Multiple discrete epithelioid granulomas with Schaumann bodies
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