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A teenage girl presented to the emergency department with hand and foot swelling and pain in areas of sun exposure after playing golf outside. She had a history of similar yet milder skin eruptions with sun exposure over the prior 2 years. No other family members were similarly affected. The physical examination findings were notable for acral edema and well-demarcated, tender petechial patches on the dorsal surface of the hands and feet (Figure, A and B). No vesicles were noted. A punch biopsy specimen from the affected area of her hand was obtained (Figure, C and D).
Song H, Liu KJ, Huang JT. Recurrent Photodistributed Skin Eruptions in a Teenage Girl. JAMA Dermatol. 2016;152(8):937-938. doi:10.1001/jamadermatol.2016.0650