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May 2006

A Slowly Enlarging, Unilateral, Erythematous Macular Lesion—Quiz Case

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Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Dermatol. 2006;142(5):641-646. doi:10.1001/archderm.142.5.641-d

A healthy 42-year-old woman presented with an asymptomatic erythematous macular lesion that was affecting the right side of her trunk and the proximal aspect of her right arm. The lesion had initially appeared on her abdomen when she was 18 years old and had been slowly enlarging since then. She described episodic flushing and occasional generalized redness after stressful situations.

Physical examination revealed multiple 5- to 10-mm, discrete, ill-defined erythematous macules on the right side of the abdomen and chest and on the proximal area of the right arm. None of the lesions extended past the midline of the trunk (Figure 1). The macules showed fine telangiectases, which blanched on diascopy and urticated on rubbing. A skin biopsy specimen was obtained and stained with hematoxylin-eosin (Figure 2).