Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Petechial angiomata are benign vascular skin tumors, that typically present as flat, irregularly shaped spots ranging from bright red to purple in color, measuring approximately 0.2 to 3 mm in diameter. They are primarily found on the trunk and proximal extremities. We report atypical petechial angiomata with acral involvement in a 75-year-old woman. She had a history of bladder cancer that was treated surgically and had been on raloxifene therapy for osteoporosis for approximately 4 years. Histopathologic finding revealed dilated vascular channels and an enlarged capillary lake within the papillary dermis surrounded by tortuous capillaries. Immunohistochemical analysis showed positivity of CD31 in the entire cell lining, but negativity for D2-40. To our knowledge, acral involvement in petechial angiomata has not been reported previously. Although both the nosology and pathophysiology of this feature remain unclear, endothelial dilation related to long-term raloxifene medication may contribute to the development of atypical vascular lesions.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterized by non-infectious ulceration of the skin. It is associated with various systemic diseases, including Takayasu arteritis (TA), rheumatoid arthritis, and inflammatory bowel disease. Notably, the co-occurrence of PG and TA is more frequent among Asians. Here, we present a rare case of TA associated with PG. A 42-year-old woman presented with recurrent ulcers affecting her legs, trunk, arms, and face, which had been refractory to various treatments for 7 years. Recently, the patient had experienced weakness in her left leg, dizziness, and a fever that had persisted for more than a month. Computed tomography angiography revealed thickening and irregularities in the common carotid arteries, right subclavian artery, and aortic arch. TA was diagnosed, following which treatment was initiated with systemic corticosteroids. It is important to consider TA in patients with PG, particularly in young women.

Kaposi’s varicelliform eruption (KVE) is a rare viral infection primarily caused by herpes simplex virus (HSV). This condition frequently presents concomitantly with underlying chronic skin disorders, particularly atopic dermatitis (AD). This report describes a rare case of sepsis resulting from KVE in a patient with AD. A 30-year-old male patient with a history of AD presented with painful skin lesions characterized by papulovesicular eruptions, crusts, erythema, and erosions, initially localized to the neck and spreading throughout his body, accompanied by a high fever. Laboratory findings confirmed HSV infection and sepsis. Thus, a diagnosis of KVE compounded by sepsis was established. Systemic acyclovir and antibiotics led to complete recovery within 3 weeks, with resolution of fever and skin manifestations, and general health improvement. Timely recognition and management of KVE are crucial for prevention of adverse outcomes. Both physicians and patients with AD should be made aware of the predisposing factors and risks associated with KVE.