A 33-year-old man in otherwise good health presented with a pruritic rash on his trunk and face of 3 months' duration. The lesions developed rapidly over 2 weeks. Subsequently, no lesions resolved, nor did new lesions appear. Various over-the-counter lotions, as well as topical and oral corticosteroids, topical antifungal agents, and topical retinoids failed to affect the appearance of the eruption or the associated intense pruritus.Physical examination disclosed numerous slightly oval, flesh-colored to slightly hyperpigmented, flattopped papules concentrated on the chest, but also scattered over the face and back (Figs 1 and 2). A punch biopsy specimen of a papule is shown in Figs 3 and 4.
A cirsoid aneurysm, which is an abnormal arteriovenous connection, occurred in a 65-year-old man. The lesion can vary greatly in size and does not have a characteristic histologic picture. Small lesions require no treatment.
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