A spreading pigmented eruption over a surgical site

Reticulated skin lesions over surgical sites may represent a rare reactive process such as intravascular histiocytosis or reactive angioendotheliomatosis, particularly in elderly patients with a history of orthopaedic procedures. Histopathological examination is essential to confirm the diagnosis, revealing intravascular aggregates of CD163+ or CD68+ histiocytes. Treatment responses to topical therapies are often suboptimal, addressing the underlying cause (eg: surgery, inflammation) remains the most effective management.