A 72-year-old white woman presented with an 18-month history of severely pruritic, erythematous, telangiectatic macules localized to the trunk, buttocks, and upper part of the thighs. She complained of night sweats, intermittent nausea, vomiting, and diarrhea, but denied any flushing, heart palpitations, or syncope.
Her medical history was unremarkable except for a previously diagnosed dermatomyositislike eruption associated with proximal muscle weakness, which had resolved after a course of prednisone several years earlier. There was no family history of dermatologic disease. Physical examination revealed the presence of red-brown, telangiectatic, ill-defined macules measuring 4 to 7 mm in diameter and involving the trunk, buttocks, and upper part of the thighs. The lesions blanched with diascopy and did not urticate on stroking (Figure 1). No hepatosplenomegaly was noted.
Norton AB, Kovach RF, Jackson JB, Touma SC. Pruritic Erythematous Macules in a 72-Year-Old Woman—Quiz Case. Arch Dermatol. 2003;139(12):1647-1652. doi:10.1001/archderm.139.12.1647-a