The cutaneous manifestations most frequently associated with polycythemia vera are a purplish-red discoloration of the skin and mucous membranes and ecchymoses particularly over the lower extremities. Both of these manifestations are readily understandable on the basis of the increase in total red cell volume characteristic of this disease.
In addition to these commoner cutaneous manifestations, acne urticata has been described in association with polycythemia vera more frequently than any other eruption. The term acne urticata was first used by Kaposi1 to designate a chronic, severely pruritic eruption characterized by the development of pale red elevated wheal-like papules, ranging from the size of a pea to that of a small coin, surmounted by a vesicle with turbid contents. The vesicle or pustule is rapidly excoriated, and the surface of the papule becomes crusted. Involution occurs, with the formation of a delicate scar and hyperpigmentation. The eruption
BAXTER DL, LOCKWOOD JH. Acne Urticata Polycythemica: Report of a Case. AMA Arch Derm. 1958;78(3):325–329. doi:10.1001/archderm.1958.01560090039009
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