Abstract:

A 48-year-old female presented with a 6-year history of papules and plaques all over the body and with 1-year history of blurred vision in the right eye. Physical examination showed porcelain-white atrophic papules with peripheral erythematous halo and telangiectasia. She also suffered from exotropia, visual deterioration, visual field defects of the right eye, as well as numbness of the left index finger, thumb and right anterior tibia. Skin biopsies of abdominal lesions revealed dermal necrosis with mucoid degeneration, inflammatory infiltration predominated by lymphocytes around several small blood vessels and occlusion of some blood vessels in deep dermis. Colonoscopy of the whole colon demonstrated scattered patches of hyperemia and erosions with the formation of shallow ulcers. Nerve electromyologram revealed damage to the nerves of right quadriceps femoris muscles. Fecal analysis showed that occult blood was strongly positive. A diagnosis of malignant atrophic papulosis was made based on the characteristic clinical presentation, laboratory and histopathological findings. She was treated with dipyridamole and aspirin for three months, which resulted in no clinical improvement or deterioration.