Ann Dermatol.  2011 Sep;23(Suppl 1):S48-S52. 10.5021/ad.2011.23.S1.S48.

A Case of Poikiloderma Vasculare Atrophicans

Affiliations
  • 1Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. sjyun@chonnam.ac.kr

Abstract

Poikiloderma vasculare atrophicans (PVA) is a rare variant of mycosis fungoides, and is characterized by generalized hyperkeratotic scaly papules in net-like, retiform, or zebra-like patterns. A 59-year-old Korean woman presented with asymptomatic, erythematous-to-violaceous, reticulated confluent papules on the trunk and extremities. Skin lesions were initially limited to both thighs 25 years ago, and then spread slowly over her body. Histopathological examination showed band-like inflammatory infiltrations and epidermotropism consisting of mostly CD8+ lymphocytes. Based on the clinical manifestations and histological findings, the diagnosis of PVA was made. We herein report on a case of PVA, which featured a long-benign course without progression into the tumor stage over a period of 30 years.

Keyword

CD8-positive T lymphocytes; Mycosis fungoides

MeSH Terms

Extremities
Female
Humans
Lymphocytes
Middle Aged
Mycosis Fungoides
Skin
Thigh

Figure

  • Fig. 1 Erythematous hyperkeratotic confluent papules with a reticulated or net-like pattern on her trunk and upper extremities (A), abdomen (B), and both thighs (C).

  • Fig. 2 Skin biopsy specimen from the thigh in 2006 shows compact hyperkeratosis, thinned epidermis, and band-like inflammatory cell infiltrations of mostly lymphocytes with dilated capillaries in the upper dermis (A, H&E; ×40). On high power view, focal parakeratosis, epidermotropism of atypical lymphocytes in the epidermis, and abnormal, wiry patterned collagen bundles in the upper dermis (B, H&E; ×200), and a CD8-positive reaction of infiltrative lymphocytes in immunochemical study (C, CD8; ×200) are shown.

  • Fig. 3 Skin biopsy specimen from the thigh 25 years ago shows perivascular inflammatory cell infiltrations of mostly lymphocytes in the upper dermis (A, H&E; ×40), epidermotropism of atypical lymphocytes in the epidermis (B, H&E; ×200), and a CD8- positive reaction of infiltrative lymphocytes in immunochemical staining (C, CD8; ×200).


Cited by  1 articles

Poikiloderma Vasculare Atrophicans Showing Features of Ashy Dermatosis in the Beginning
Jiehyun Jeon, Joo Ha Kim, Jae Woo Ahn, Hae Jun Song
Ann Dermatol. 2015;27(2):197-200.    doi: 10.5021/ad.2015.27.2.197.


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