dren. 1 Its aetiology is unknown, but it has been considered a dermal hypersensitivity reaction associated with viral infections (Echovirus, Coxsackie B, Epstein-Barr, Cytomegalovirus), drugs (including chemotherapy), foods, herbal medicine (deer horn, gingko nut, Kalopanax pictus), allergens and malignancies (acute lymphoblastic leukaemia). [2][3][4] Eruptive pseudoangiomatosis manifests as lesions consisting of small erythematous angioma-like papules with a perilesional pale halo, most commonly found in the extremities. 3 A prodrome of fever, sore throat or gastrointestinal symptoms is usually present. 1,3 It tends to resolve spontaneously in 1-2 weeks in children and 1-3 months in adults without sequelae; nevertheless, recurrences have been reported. 2 Less common in adults, the first cases were reported in 8 women and 1 man with an acute rash of numerous erythematous and telangiectatic papules on the face, limbs and trunk. 5 Unlike children, in adults, there is a predominance in women with no prodrome and a longer duration. 1 Our case was atypical, being a male patient with an axial distribution affecting the scalp, face and trunk with a duration of approximately 2 years.Routine laboratory test are normal. Occasionally, there is leukopenia and lymphocytosis. 3 Echovirus identification and positive serology for Epstein-Barr and Coxsackie virus along with prodrome, familial cases and a seasonal presentation during summer point to a viral aetiology. 1,4 However, most patients do not have a confirmed infectious aetiology. Histopathology shows dilated dermal blood vessels with plump endothelial cells and a mild to moderate lymphohystiocitic perivascular infiltrate. There is no evidence of vascular proliferation in the dermis or vasculitis. 2 Differential diagnosis includes viral exanthema, papular urticaria, multiple eruptive capillary hemangiomas, insect bites and leukocytoclastic vasculitis, among others. 1,3 No specific treatment is needed; however, pruritus can be managed with oral antihistamines and topical steroids, but this does not change the course of the disease. 2,3 A chronic and persistent evolution of 2 years and an axial distribution sparing the limbs make this an atypical case of eruptive pseudoangiomatosis.
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