Telangiectasia macularis eruptiva perstans (TMEP) is a rare disease, previously classified as a variant of cutaneous mastocytosis. While no gold standard of treatment exists, several treatments have been studied. We report a case of a 63-year-old woman who presented with long-standing asymptomatic telangiectatic macules beginning on the upper chest, back, and bilateral arms, with occasional pruritus and no other systemic symptoms. Skin biopsy, along with Giemsa stain, revealed findings consistent with TMEP. The patient underwent testing for serum tryptase level, which was within normal limits. The patient was started on topical steroids for two weeks and antihistamine therapy, with a noted decrease in pruritus but no change in cutaneous lesions. She was then advised to start phototherapy, and subsequently underwent a total of five sessions of narrow-band ultraviolet B phototherapy, after which she noted lightening of the lesions. Due to the COVID pandemic, the patient was shifted to heliotherapy with continued lightening of lesions after two months of thrice weekly sessions. This rare case is supportive of narrow-band ultraviolet B phototherapy and heliotherapy as promising treatment options for cases of TMEP.
mastocytosis ; phototherapy ; heliotherapy

: Pityriasis lichenoides (PL) is an inflammatory papulosquamous condition that exists in a continuous spectrum that consists mainly of pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica (PLC). The condition has been reported to erupt in response to infections, radiocontrast media, medications and vaccines. Most case reports on vaccine-related eruption involve the acute PL, hence, this report aimed to present a case presenting with lesions of the chronic variant. : A 21-year-old female presented with multiple erythematous to hyperpigmented ill defined plaques, some ulceronecrotic, topped with fine scales and excoriations on the upper and lower extremities, periumbilical area and back of 4 months duration, following rabies vaccinations. : Histopathologic findings, including interface dermatitis, parakeratosis, spongiosis, and mixed inflammatory infiltrates, confirmed the diagnosis of PLC. The patient responded well to oral corticosteroids and heliotherapy. PL is rare and requires additional research. The potential role of vaccination as an etiologic agent represented a crucial area of this investigation. Additionally, heliotherapy should be considered as a viable therapeutic alternative when phototherapy is not feasible.. Further research is needed to elucidate the pathogenesis of PL and establish evidence-based treatment protocols.
Pityriasis lichenoides chronica ; Pityriasis lichenoides ; heliotherapy ; vaccine