A 10-year-old boy presented with a one-week history of slightly itchy, bilateral symmetrical weal-like lesions confined to the thighs. The lesions were persistent (not evanescent), devoid of purpuric elements and on closer examination few lesions had targetoid appearance. He had no history of a preceding infection or drug intake. He was diagnosed as an urticaria-like EM and was given an oral antihistamine (Cetrizine) plus twice daily applications of Mometazone furoate cream with complete disappearance of the rash within 10 days.
A few months after accidental self’s lip bite, an asymptomatic, small, oval, smooth-surfaced, pale pink nodule arouse from the buccal surface of the lower lip. It was removed by electrocautery under local anesthesia.
An 18-month-old male baby presented with faint red patches confined to one side of the face (cheek, upper lip and nose). The vascular defect has been noticed since birth and characteristically, it respected the mid-line. The severity of port-wine stains is variable as it can be very extensive and dark red in color on the other hand it may be of limited extent and faint or even hardly noticeable defect.
A 21-year-old male presented with multiple asymptomatic circinate plaques on both sides of the nose of 4 months duration. The patient is bothered by the cosmetic appearance of the lesions. On examination, the lesions were well demarcated, circular plaques surrounded by slightly elevated borders (keratotic collars) and atrophic centers i.e. they have festooned appearance.
A 5-year-old girl presented with multiple, large-sized, pinkish wheals involving most of the body areas especially the face, arms and hands of 48 hours duration. The eruption associated with severe itching. The mother noted that some lesions appearing while others disappearing within a matter of few hours during the two days of rash persistence. There was negative drug history but one hour prior to the onset she drank banana-flavored milk. There were no fever or other associated systemic symptoms.
A 52-year-old woman presented with a well-demarcated, severely pruritic, red scaly plaques with exaggerated skin lines involved the extensor surface of the extremities especially the knees of 5 years duration.