He’s back! Biopsy from the chest of a 60+ year old woman. What do you think is going on here?

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Gottlieb’s sandwich sign: Fungal hyphae are “sandwiched” between two zones of cornified cells: orthokeratosis on top & parakeratosis or compact orthokeratosis below. Can be used as a clue for low power dx of dermatophyte infection.

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