Eruptive Pseudoangiomatosis: Report of an Adult Case and Unifying Hypothesis of the Pathogenesis of Paediatric and Adult Cases

Abstract

One month after the onset of immunosuppressive treatment with corticosteroids and mycophenolate mofetil for a newly diagnosed pemphigus vulgaris, a 50-year-old female patient developed a new eruption clinically and histomorphologically consistent with eruptive pseudoangiomatosis (EP). Its self-limited course further confirmed this diagnosis. Although initially described as a paediatric eruption, meanwhile more adult cases of EP (30 out of a total of 53 cases identified by a Medline search) are reported in the literature. The review of adult cases of EP disclosed some common clinical and epidemiological characteristics: adult EP cases tend to cluster in the Mediterranean region of Europe, develop during the summer months, sometimes in the form of limited micro-epidemics, affect immunocompromised individuals and have lesions confined to the exposed skin sites. These characteristics, together with the exanthematic nature of the disease in children, point to some vector-transmitted infectious agent as the cause of this probably underdiagnosed disease.

A Case of Recurrent Eruptive Pseudoangiomatosis That Responded Well to Pimecrolimus 1% Cream

“…Mild perivascular lymphocytic and sparse eosinophilic infiltration are obvious in the superficial and middermis [5] . Extravasation of red blood cells is an occasional pathological finding [7] .…”

“…In pediatric patients, fever, headache or upper respiratory tract infection are common prodromal symptoms, which contrasts with the adult condition that tends to lack these symptoms (as seen in our case). Lesions are supposed to resolve quicker in the adult case (1-2 weeks) than in children (usually 1 month) [4][5][6] . All 15 adult patients so far reported (including the present case) were females, if cases with mosquito or insect bite were excluded.…”

A Case of Eruptive Pseudoangiomatosis

“…7,12 Erüptif psödoanjiyomatoz tanımlama kriterleri; çevresinde anemik halo olan ve farklı boyutlarda asemptomatik lezyonların olması (yüzdeki lezyonların çevresinde anemik halo olmayabilir), erişkin hastalarda lezyonlarda birleşme olmaması, sistemik semptomların yokluğu ve döküntünün bir haftadan uzun sürmesidir. 2,4,[14][15][16] En sık etkilenen bölgeler yüz ve ekstremitelerdir. Lezyonlar iki-dört hafta (ortalama 18 gün) devam eder.…”

“…Hastanın rutin laboratuvar incelemelerinde patolojik bulgu saptanmamış ve histopatolojik inceleme erüptif psödoanji-yomatoz ile uyumlu bulunmuştur. 15 Olgumuzda kronik hastalık ve ilaç kullanım öyküsü yoktu.…”

Clinicopathologic review of eruptive pseudoangiomatosis in Korean adults: report of 32 cases

“…The first adult cases of EP were reported by Guillot and Dandurand in 2000 4 . Although the disease was initially reported as an exanthematic disease in children, 57 cases with adult onset have subsequently been reported 4–9 . The current study was performed to further evaluate the etiologic, clinical, and histopathologic characteristics of EP in Koreans.…”