case_images: PMC11785579_01
case_images: Numerous pink, indurated papules and crusted brown papulonodules with superficial lichenification and excoriation noted diffusely over the lower extremities (A and B).
case_images: gr1.jpg
case_images: PMC11785579_01_gr1.jpg
case_images: fig1
case_images: Physical exam revealed pink, indurated papules and crusted brown papulonodules with superficial lichenification and excoriation scattered on the lower extremities (Fig 1).
case_images: Histopathologic section revealing parakeratosis and vacuolar interface changes in the basal cell layer, accompanied by a lymphocytic infiltrate (interface dermatitis). There are moderately dense perivascular lymphocytic infiltrates in the superficial and mid-dermis (hematoxylin-eosin, x200 (A), x400 (B)).
case_images: gr2.jpg
case_images: PMC11785579_01_gr2.jpg
case_images: fig2
case_images: Extravasated erythrocytes were also observed within the papillary dermis (Fig 2).
case_images: After treatment with doxycycline 100 mg twice daily for 3 months.
case_images: gr3.jpg
case_images: PMC11785579_01_gr3.jpg
case_images: fig3
case_images: At a follow-up visit 3 months later, the patient had significant improvement with a reduction in lesions (Fig 3).