A Case of Recurrent Eruptive Pseudoangiomatosis That Responded Well to Pimecrolimus 1% Cream

Angiomatous papules ؒ Eruptive pseudoangiomatosis ؒ Pimecrolimus cream Eruptive pseudoangiomatosis (EPA) is a benign, asymptomatic and self-resolving disorder that is characterized by the sudden appearance of angiomatous-like papules [1,2] .The consensus that EPA preferentially affects children had not been queried until Navarro et al. [3] reported their first adult case in 2000.We herein report a frequently relapsing adult case that was successfully controlled with pimecrolimus 1% cream.A 69-year-old Chinese female complained of angiomatous papules on the face and the dorsal surfaces of her hands.The lesions had first appeared on the face and the extensor surface of the hands 6 months earlier, however they had not been accompanied by a high fever or other prodromal symptoms.Since then, similar lesions had relapsed at the same site after a quiescent period of approximately 10 days.Each occurrence lasted 12-18 days, and occurred without sequelae.There was no itching or other abnormal sensations, nor were there urticaria, purpura, ulceration, papulovesicle or overlying scales.The patient was otherwise well and she denied a previous history of insect bites or drug use.Previous treatment with oral citirizine tablets had been unsuccessful and had not prevented relapses.On examination, angiomatous papules with diameters of between 2 and 5 mm were noted on the face and dorsal surfaces of the hands.Scales, ulcerations and crusts were not observed ( fig. 1, 2 ).There were no similar lesions on other parts of the body.The red papules blanched completely with pressure and rapidly refilled from the center after release.Analyses of the lymph nodes, spleen and liver revealed no abnormalities.Routine laboratory tests were normal, and serological testing for echovirus, cytomegalovirus, parvovirus B19, hepatitis B and C viruses and human immunodeficiency virus were all negative.Autoantibodies and a serial of tumor markers (AFP, CEA, FER, ␤ 2Mg, CA-50, CA125) were all in normal ranges.