case_images: PMC2651115_01
case_images: (A) Generalised hyperpigmented maculopapular rash. Palms, soles and face are also involved. (B) Darier sign: stroking the papular lesion linearly with a blunt instrument gives rise to linear wheal in (C).
case_images: 1757-1626-2-69-1.jpg
case_images: PMC2651115_01_1757-1626-2-69-1.jpg
case_images: F1
case_images: Examination revealed multiple oval/round hyperpigmented papules and plaques distributed all over the body (face, trunk, extremities and acral areas too)(Fig. 1-A). Darier's sign (papular lesion becomes a palpable wheal after being vigorously rubbed) was positive.(Fig. 1-B &1-C) Pruritus was exaggerated after emotional excitement.** Patchy non-scarring scalp alopecia was present.
case_images: Plenty of spindle shaped cells with eosinophilic cytoplasm i.e. mast cells infiltrate the dermis and the appendiceal structures (black arrows). The basal cells show more pigmentation (blue arrows) A:H & E, 10x; B: H & E, 40x.
case_images: 1757-1626-2-69-2.jpg
case_images: PMC2651115_01_1757-1626-2-69-2.jpg
case_images: F2
case_images: The basal cells showed more pigmentation (blue arrows).(Fig. 2) Complete hemogram, skeletal survey, liver function tests, blood coagulation profiles were normal.