Additionally, one may observe a dense dermal infiltrate of vacuolated cells, along with wreathlike giant cells (Touton cells
) and eosinophils.
(14) Touton cells
are large, lipid-laden histiocytes with multiple nuclei arranged around a central island of cytoplasm.
The cellular infiltrate also includes various proportions of giant cells, Touton cells
, lymphocytes, eosinophils, and neutrophils.