LAUSR

Patient 1 was a 63-year-old woman who presented a 3-month history of itchy rash on limbs and trunk. Three months ago, the patient suffered from bad cold with cough and runny nose. She took acetaminophen (Tylenol) for treatment (acetaminophen had been taken for numerous times) and recoveredafter10days. Subsequently, thepatient noted a mildly pruritic papular eruption involving her abdomen and sacrococcygeal region. This eruption progressed to involve her arms and legs. Physical examination revealed multiple violaceous round papules and plaques over her abdomen, sacrococcygeal region, arms, and legs [Figure 1A]. Wickham striae could be barely observed on the lesions. No oral lesions were present. Hepatitis serology was negative. We examined the lesions on the sacrococcygeal region with dermoscopy (CH-DSISI-2000, desktop dermoscopy, Guangzhou Chuanghong Medical Technology Co., Ltd, China). The results showed annular crystalline white striae accompanied with prominent linear vessels at the periphery with a characteristic radial distribution [Figure 1B]. The diagnosis was confirmed by biopsy. The histology showed wedge-shaped hypergranulosis, acanthosis, liquefaction degeneration of basal cells, and band-like dermal lymphohistiocytic infiltration [Figure 1C]. The patient was treated with topical halometasone cream and tacrolimus ointment, which were applied daily to the lesions. The patient refused to take oral corticosteroid. During the 2 weeks of follow-up, the patient’s condition improved. Over the next 2 weeks, she continued topical treatment and had further recovery.