A 3-year-old girl presented with two pruritic urticated papules with central puncta strangely involved both shins in a mirror-image like pattern of few days duration. Note the symmetry of lesions and as I often state that insect’s bite doesn’t succumb to logic so may take any pattern !!!
Lichen amyloidosis is characterized by closely set, discrete, brown-red papules that often show some scaling and are most commonly located on the legs, especially the shins, although they may occur elsewhere. Through the coalescence of papules, plaques may form on the legs. These plaques often have verrucous surfaces and then resemble hypertrophic lichen planus or lichen simplex chronicus. Usually the lesions of lichen amyloidosis itch severely. The presented patient has had typical lesions of lichen (papular) amyloidosis on her shins of more than 2 years duration. The lesions caused great troublesome to the patient through severe itching and cosmetic appearance.
A 26-year-old primigravida woman in her third trimester presented with severely pruritic erythematous papules involving mainly the abdomen and also the extremities of two weeks duration. The rash has started at the umbilical region and spread to other areas.
A 4-year old girl presented with multiple ecchymotic lesions of varying sizes involving the forehead, arms and legs of two weeks duration. Her mother said that one week before the onset of the condition her daughter suffered a febrile disease lasted about 5 days. There was no history of bleeding from any part of the body and negative drug history before purpuric manifestations. Family history of bleeding tendency also was negative. On investigations the CBC was normal apart from reduced platelets count which was 60000/mm3. Bone marrow examination showed normal megakaryocytes no. and morphology.
A 55-year old man presented with a painful keratotic papule on the helix of the ear of 6 months duration. It has been excised under local anesthetic. Histologically was consistent with Chondrodermatitis nodularis helicis.
A 38-year-old married woman presented with an irregular, clear-cut, longitudinal crusted ulcer about 12×2.5 cm with pinkish red border involved the flexor aspect of the upper part of the forearm of 1 month duration. The ulcer seems to be self-induced with a caustic material (chemical burn) but the patient denied any history of self-mutilatin. The ulcer appearance which didn’t fit any ulcerative dermatological entity and the rapid evolution in addition to non-specific histological findings on skin biopsy may permit the diagnosis of dermatitis artefacta.
A 38-year-old man presented with a six-month-history of multiple, asymptomatic, pinkish annular plaques with beaded borders on the dorsum of one hand. The patient has no DM or any other disease. Biopsy was compatible with GA.
A 50-year-old woman presented with an asymptomatic solitary translucent cyst containing clear fluid involved the lateral canthus area of many months duration. The lesion had been excised totally and sent for HP examination which was consistent with hydrocystoma.