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A Case for Diagnosis (Eruption of Chest and Back, Aggravated by Sunlight). Presented by Dr. Jack Wolf.
R. M., a woman aged 24, is presented with an eruption of approximately four years' duration, which began in the presternal region and gradually spread peripherally until it reached its present size. Satellite lesions have continued to appear. The only relevant observation that the patient has made is that the eruption becomes more acute on exposure to the sun but that it does not necessarily spread as a result of such exposure.
On examination the patient presents a diffuse mottled erythematous eruption, forming a more or less reticulated pattern and extending from the supraclavicular regions down to the inframammary area. Laterally it extends as far as the midclavicular line. The individual lesion is barely perceptible to the touch, and the elevation can be seen only when observed at the proper angle.
Lewis GM, Sachs W. MANHATTAN DERMATOLOGIC SOCIETY. Arch Derm Syphilol. 1946;54(5):597–603. doi:10.1001/archderm.1946.01510400103017