Figure 1: (A) Erythematous papules on the lower abdomen at sites between T9 and T11
(B) The magnified view of several papules with mica-like scale
Histopathological examination showed hyperkeratosis, focal parakeratosis, acanthosis, moderate lymphocytic exocytosis, a few necrotic keratinocytes and vacuolization of the basal layer in the epidermis, mild superficial perivascular lymphocytes infiltration, extravasated red blood cells in the dermis. Immunohistochemical staining demonstrated that most of the lymphocytes in the infiltrate were CD4 positive, CD30 negative. These histological findings were compatible with PLC.
In a laboratory investigation, complete blood cell count, liver, and kidney function tests, urine analyze, erythrocyte sedimentation rate were normal. Serologic markers were negative for hepatitis A, B, and C virus, CMV, EBV, HIV, parvovirus, rickettsia, VDRL, TPHA, salmonella, mycoplasma, and ANA. Anti-streptolysin O titers, ANA, throat culture were negative or normal.
The patient was treated with topical methylprednisolone aseponat (0.1% twice daily). His lesions cleared leaving some hypopigmentation, but lesions continued to recurrent on the same region after two months of treatment. His family did not accept the UVB treatment.