Histopathologic analysis showed dilated vessels with a mild diffuse and perivascular infiltrate of mononuclear cells and neutrophils on hematoxylin-eosin staining, consistent with the patient's known AOSD. A diagnosis of a heliotrope-like manifestation of AOSD was given.
The patient was treated with Vaseline (Unilever). Though her heliotrope eruption improved somewhat, it never remitted completely. She noted worsening of the heliotrope during a systemic flare (eg, arthralgias) of her AOSD.