Winter eruption on the thighs

Abstract

Conflict of interest: the authors declare that they have no conflicts of interest. A 66‐year‐old woman presented with a 5‐day history of an eruption on her thighs associated with mild pruritus. She had been self‐treating with topical neomycin without improvement. The patient had a history of diabetes, hyperlipidaemia, obesity and hypertension, and did not report any changes in medication. She did report walking frequently outdoors despite cold winter temperatures. Physical examination revealed a pink, nonscaly eruption of mildly oedematous patches and plaques, with a somewhat reticulated border, limited to the anterolateral thighs (Fig. 1). A punch biopsy was taken. ... Histopathological examination revealed a normal epidermis with mild underlying subepidermal oedema, as well as a dense superficial and deep perivascular lymphoid infiltrate (Fig. 2a). Conspicuous involvement of eccrine coils was noted as well as extension into the upper subcutis (Fig. 2b). ... What is your diagnosis?