PMC10360453_01
a Poorly defined erythematous plaques with a vague reticular pattern in a characteristic midline distribution. b Spreading of the erythema to the neck and interscapulo-vertebral area. c Remission of the skin lesions following treatment with antimalarial agents.
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F1
The cutaneous lesions were located on the right pectoral area, right shoulder, and right side of the neck, tending to spread towards the midline of the back (Fig. 1a, b). The treatment led to prompt resolution of the lesions after 3 months of initiating the antimalarial therapy (Fig. 1c).
a Regular epidermis with mild predominantly lymphocytic inflammation in perivascular and periadnexal location (H&E, original magnification, x40). b Alcian blue stain highlights the area of mucin deposition in the superficial/mid-dermis. Mucin splaying collagen fibres (original magnification, x100).
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F2
Alcian Blue stain at pH 2.5 (Fig. 2b). A moderate perivascular and patchy periadnexal lymphocytic infiltrate was demonstrated in the superficial and mid-reticular dermis without features of vasculitis.
DIF showing faint granular positivity for IgM along the basal layer.
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F3
C3, IgG, and IgE (Fig. 3). Chest roentgenogram, skeletal radiological studies, and abdominal ultrasound were within normal parameters.