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August 1989

Springtime Papules, Plaques, and Cheilitis

Author Affiliations

Louisiana State University Medical Center, Shreveport

Arch Dermatol. 1989;125(8):1131-1132. doi:10.1001/archderm.1989.01670200107021

REPORT OF A CASE  A 19-year-old mestizo Chippewa Indian woman presented with a lifetime history of a recurrent springtime pruritic eruption on her arms and face. Her father and brother had histories of a similar rash.Physical examination disclosed multiple excoriated erythematous papules on the extensor surfaces of the arms that appeared somewhat urticarial (Fig 1). A small plaque was noted on the right malar area of the face (Fig 2). Cheilitis of the lower lip was present (Fig 3).Laboratory data, including complete blood cell count, blood chemistry, urinalysis, and erythrocyte protoporphyrin levels, were normal. Rapid plasma reagin and antinuclear antibodies were negative. Representative sections of the biopsy specimen are shown in Fig 4.What is your diagnosis?

DIAGNOSIS:  Polymorphous light eruption (PMLE).

HISTOPATHOLOGIC FINDINGS  There was marked edema of the papillary dermis, and a dense lymphocytic perivascular infiltrate in the