Brownish asymptomatic lesions on the arms and legs

Abstract

A 37-year-old Caucasian man presented with a two-year history of brownish lesions on his limbs. No therapy had been started, owing to the absence of itch or pain. One year after the appearance of the cutaneous lesions, epilepsy was diagnosed, and oral lamotrigine treatment was administered. Physical examination revealed multiple brownish to purpuric patches surrounded by some erythematous papules on the arms and legs (Figure 1). The results of blood tests were within normal ranges, including platelet count, erythrocyte sedimentation rate (ESR), lactate dehydrogenase level (LDH) as well as liver and renal function. Negative test results were found for syphilis, HIV, HBV, HCV, Epstein-Barr virus (EBV IgM and IgG), human herpesvirus (HHV IgM, IgG-1 and Ig-2), parvovirus B19 (IgM and IgG), antinuclear antibodies (ANAs), extractable nuclear antigen and anti-DNA antibodies.