Recurrent erythematous papules on chest: A case report
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A 40-year-old man with no significant medical history presented with a 10-year relapsing and remitting rash. The lesions were pruritic, painless, pink papules and plaques on his chest in a net like configuration which were exacerbated by sunlight exposure and without a family history of similar cutaneous lesions. Physical examination was unremarkable; ancillary testing included CBC, basic metabolic panelviral serology for HIV, HBV, and HCV, and chest X-ray which were within normal limits.

Autoantibody tests: antinuclear antibodies (ANA), antibodies to double-stranded DNA and autoantibodies against Ro/SSA, La/SSB, Smith antigen were negative. Application of high-potency topical corticosteroids resulted in minimal therapeutic response. A biopsy was performed for histopathological analysis. A rare chronic disorder of dermal mucin accumulation exacerbated by sun exposure was diagnosed. It predominantly affects the chest and upper back area in a reticulated pattern of lesions. Histologically, a perivascular lymphohistiocytic infiltrate is noted and mucin is vastly present in the papillary dermis.

In general, REM is not related to systemic diseases, but reports of a potential association have been documented. In particular, concomitant autoimmune disease, thyroid disease (Hashimoto disease and hyperthyroidism) and malignancies of the lung, breast, and colon have been reported.

Source: https://www.jaadcasereports.org/article/S2352-5126(20)30769-4/fulltext?rss=yes
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