PMC10290853_01
Clinical manifestations: (A) multiple discrete indurated erythematous-to-brownish papules, some coalescing into plaques on the pretibial skin and multiple varicose veins; close-up pictures of the right (B) and the left legs (C).
CCID-16-1589-g0001.jpg
PMC10290853_01_CCID-16-1589-g0001.jpg
f0001
Varicose veins were also present on both legs (Figure 1).
Dermoscopic features: dotted and globular vessels (blue arrows) over pinkish-white and brownish backgrounds with hemorrhagic crusts (green stars) (original magnification x20).
CCID-16-1589-g0002.jpg
PMC10290853_01_CCID-16-1589-g0002.jpg
f0002
The dermoscopic evaluation found dotted and globular vessels over pinkish-white and brownish backgrounds with hemorrhagic crusts (Figure 2).
Histopathological findings (hematoxylin-eosin): (A) epidermal hyperplasia with flattening of rete ridge (original magnification x40) and (B) hyperkeratosis with parakeratosis (original magnification x100), (C) plump endothelial cell-blood vessels with dense superficial perivascular cell infiltration (original magnification x100), (D) interstitial infiltration of stellate fibroblasts (original magnification x600).
CCID-16-1589-g0003.jpg
PMC10290853_01_CCID-16-1589-g0003.jpg
f0003
Numerous stellate fibroblasts and some Langerhans cell granulomas were also observed (Figure 3).
One month after additional oral pentoxifylline, (A) all lesions flattened into patches; close-up pictures of the right (B) and the left legs (C).
CCID-16-1589-g0004.jpg
PMC10290853_01_CCID-16-1589-g0004.jpg
f0004
Interestingly, only 1 month after, all lesions, including intralesional corticosteroid injected and non-injected lesions, flattened into patches, and all symptoms almost resolved (Figure 4).