PMC8703221_01
Scarring papules with central ivory depression and rims of erythema on the trunk (a) and lower extremities (b).
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F1
Physical examination revealed scattered scarring papules of a mung bean size with central porcelain-white depression over the trunk, lower extremities, and genital areas, sparing the palms and face (Figures 1a,b).
Esophagogastroduodenoscopy showed multifocal raised nodules in the duodenal bulb.
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F2
An esophagogastroduodenoscopy detected multifocal raised nodules in the duodenal bulb without significant abnormalities in the esophagus, cardia, gastric fundus or corpus, stomach angle, gastric antrum, and pyloric region (Figure 2).
(a) Biopsy specimen of duodenal bulb showed focal gland dilatation and inflammatory cells infiltration with focal deposits of mucin (hematoxylin and eosin, x100). (b) Histopathologic examination of the right leg revealed thickened vascular wall with fibrinous necrosis and perivascular lymphocytes infiltration in the dermis (hematoxylin and eosin, x200).
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F3
And a biopsy of duodenal bulb demonstrated focal gland dilatation and inflammatory cells infiltration with focal deposits of mucin (Figure 3a). Biopsy of a characteristic lesion revealed thickened vascular wall with fibrinous necrosis and perivascular lymphocytes infiltration without mucin deposition in the dermis (Figure 3b).
Dermoscopy showed central porcelain-white structureless area crowded by hairpin vessels.
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F4
Dermoscopy of atrophic papules revealed a central white structureless area surrounded by hairpin vessels (Figure 4).