A white woman in her early 40s presented with generalized pruritus of 10-years' duration. She had no other medical history. The patient provided the report of a skin biopsy performed 2 years before presentation. It was described as indicating spongiotic dermatitis. She had been treated with topical corticosteroids with no control of the symptoms. Physical examination revealed erythematous papules, some of them crusted, and some excoriations located over the trunk and upper extremities (Figure 1A). In addition, some scales and fissures were seen on her lower lip (Figure 1B), sparing the surrounding skin, as well as inner mouth and upper lip. A new biopsy sample was taken to rule out actinic cheilitis.
Diagnosis
B. Actinic prurigo cheilitis
Microscopic Findings and Clinical Course