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case_images: A, B, C, D. Multiple excoriated hyperkeratotic papules and nodules with central crust involving the whole integument
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case_images: Pruritus had started 10 months before and subsequently there was onset of keratotic papules and nodules (Figure 1).
case_images: A. Acanthosis of the epidermis with hypergranulosis and ortho-parakeratosis. On the left side, cup-shaped depression of the epidermis with parakeratotic material and debris. In the dermis fibrosis, teleangiectatis vessels and aspecific lymphohistiocytic infiltrate. B. Cup-shaped depression of the epidermis which is filled by parakeratotic keratin and neutrophils. At the bottom basophilic collagen fibres in vertical orientation that are extruded
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case_images: Histopathology showed irregular epidermal hyperplasia with hypergranulosis, orthokeratosis and a cup-shaped depression of the epidermis with parakeratotic material, debris and extruded basophilic collagen fibres at the bottom (Figure 2).
case_images: A, B, C, D. Multiple postinflammatory hyperpigmentations involving the whole integument after 8 months of treatment
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case_images: Clinical response was maintained at 14-month follow-up visit with uninterrupted well-tolerated allopurinol therapy (Figure 3).