case_images: PMC10290853_01
case_images: 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).
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case_images: Varicose veins were also present on both legs (Figure 1).
case_images: Dermoscopic features: dotted and globular vessels (blue arrows) over pinkish-white and brownish backgrounds with hemorrhagic crusts (green stars) (original magnification x20).
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case_images: The dermoscopic evaluation found dotted and globular vessels over pinkish-white and brownish backgrounds with hemorrhagic crusts (Figure 2).
case_images: 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).
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case_images: Numerous stellate fibroblasts and some Langerhans cell granulomas were also observed (Figure 3).
case_images: One month after additional oral pentoxifylline, (A) all lesions flattened into patches; close-up pictures of the right (B) and the left legs (C).
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case_images: 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).