A 60-year-old woman presented with widespread pruritic insect bite-like lesions, which she firstly detected 6 months before. She neither remembered any insect sting, nor were any other contact persons affected. The medical history revealed no atopic diathesis. There was no change in medications, she had not had any recent infections and did not complain of fever, chills or malaise. In 1998 she had been diagnosed with chronic lymphocytic leukemia (B-CLL) and had undergone allogeneic peripheral blood stem cell transplantation in 2010. After achieving a complete remission, she suffered a relapse in 2011, and was currently stage IV according to Rai/Binet C. She had not received any previous dermatoloFigure 1 Overview of the legs with excoriated papules and papulovesicles on urticarial ground (a). Detailed view of a papulovesicle on urticarial base (b). Detailed view of excoriated papules on trunk (c).gical treatment. Her medications included acyclovir 200 mg 1-1-1 (every other day), folic acid 5 mg 1-0-0 (once a week), cotrimoxazole 960 mg 1-0-0 (three times a week), and ursodeoxycholic acid 250 mg 1-0-1. There was no change in medication in temporal connection with the manifestation of the insect bite-like skin eruptions.
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