disappear after pressure and reﬁll on release.
exposed sites, although they can occur on the whole body.
is asymptomatic and resolves spontaneously within 1–2 weeks.
Skin biopsy shows dilated dermal blood vessels with plump
endothelial cells, without vascular proliferation, and mild
perivascular lymphocytic inﬁltrate in the upper dermis,
observed in the biopsy of our second patient.
Most cases occur in immunocompetent patients, but there
have been several reports in immunocompromised patients.
Henry and Savasan
reported a 13-year-old male on
chemotherapy for Hodgkin lymphoma with doxorubicin, bleomy-
cin, vincristine, etoposide, cyclophosphamide, and prednisone,
who developed EPA. Neri et al.
reported a 22-month-old girl
who presented EPA at the time of the diagnosis of ALL. Both
cases had a self-limited nature, similar to our patients.
We believe either leukemia or chemotherapy could also be
regarded as some of the triggering factors for the development
of EPA. A clear relationship between EPA and these two factors
has yet to be elucidated. Since viral infections were not ruled
out in the ﬁrst patient, the association with chemotherapy as a
trigger cannot be established for both cases. Our cases, and
others of EPA in immunocompromised patients,
self-limited nature of the condition even in these hosts.
Marian K. Rivas-Calder
Celso T. Corcuera-Delgado
Dermatology Department, National Institute of Pediatrics,
Mexico City, Mexico
Pathology Department, National Institute of Pediatrics,
Mexico City, Mexico
Conﬂicts of interest: None.
1 Neri I, Patrizi A, Guerrini V, et al. A new case of eruptive
pseudoangiomatosis: ultrastructural study. J Eur Acad Dermatol
Venereol 2004; 18: 387–389.
2 Yang JH, Kim JW, Park HS, et al. Eruptive
pseudoangiomatosis. J Dermatol 2006; 33: 873–876.
3 Cherry JD, Bobinski JE, Horvath FL, et al. Acute hemangioma-
like lesions associated with ECHO viral infections. Pediatrics
1969; 44: 498–502.
4 Prose NS, Tope W, Miller SE, et al. Eruptive
pseudoangiomatosis: a unique childhood exanthem? J Am Acad
Dermatol 1993; 29: 857–859.
5 Hoeger PH, Colmenero I. Vascular tumours in infants. Part I:
benign vascular tumours other than infantile haemangioma. Br J
Dermatol 2014; 171: 466–473.
6 Chuh A, Panzer R, Rosenthal AC, et al. Annular eruptive
pseudoangiomatosis and adenovirus infection: a novel clinical
variant of paraviral exanthems and a novel virus association.
Acta Derm Venereol 2017; 97: 354–357.
7 Oka K, Ohtaki N, Kasai S, et al. Two cases of eruptive
pseudoangiomatosis induced by mosquito bites. J Dermatol
2012; 39: 301–305.
8 Kim JE, Kim BJ, Park HJ, et al. Clinicopathologic review of
eruptive pseudoangiomatosis in Korean adults: report of 32
cases. Int J Dermatol 2013; 52:41–45.
9 Henry M, Savasan S. Eruptive pseudoangiomatosis in a child
undergoing chemotherapy for Hodgkin lymphoma. Pediatr Blood
Cancer 2012; 59: 342–343.
10 Neri I, Patrizi A, Guerrini V, et al. Eruptive pseudoangiomatosis.
Br J Dermatol 2000; 143: 435–438.
Comorbidities of Japanese patients with palmoplantar
pustulosis: a report from a single center
Palmoplantar pustulosis (PPP) is characterized by small sterile
pustules, scales, crusts, and erythemas on the palms and soles.
PPP is closely related to psoriasis, and both disorders share a
common pathogenesis in multiple aspects. Recently, psoriasis
has been considered to be a chronic systemic inﬂammatory dis-
order with various comorbidities, such as metabolic syndrome,
cardiovascular diseases, uveitis, and inﬂammatory bowel dis-
eases. By contrast, to date, only a few studies on the comor-
bidities of PPP have been published.
investigated comorbidities of Japanese patients with PPP trea-
ted in the dermatology department of Fukushima Medical
In this study, we retrospectively analyzed 136 PPP patients
who visited our department in the last 10 years. Forty-four
patients were male (32.4%) and 92 were female (67.6%), with a
female predominance (M : F = 1 : 2). The mean age was
53.1 years old, and 128 patients (94.1%) had a smoking habit
(either ongoing or previous). Arthro-osteitis was most frequently
observed and conﬁrmed by bone scintigraphy (n = 41) (30.1%).
Hypertension was also frequently observed (n = 25) (18.4%),
followed by other diseases such as diabetes mellitus (n = 14)
(10.3%), dyslipidemia (n = 6) (4.4%), psychological disorder
(n = 6) (4.4%), pulmonary disorder (n = 6) (4.4%), thyroid disor-
der (n = 6) (4.4%), internal malignancy (n = 5) (3.7%), ischemic
heart disease (n = 2) (1.5%), and cerebrovascular disorder
(n = 2) (1.5%) (Table 1). Among cardiovascular diseases, all
four patients (two patients with ischemic heart disorder and two
patients with cerebral vascular disorder) were current smokers.
Among six patients with pulmonary disorder, two were current
and three were previous smokers (the remaining one was
unknown). Thyroid diseases included Hashimoto’s thyroiditis
(n = 3) and Basedow’s disease (n = 2). Three patients had
either anti-thyroid or anti-microsome antibodies. Internal malig-
nancies that were observed were lung cancer (n = 1), mam-
mary cancer (n = 2), and thyroid cancer (n = 2).
International Journal of Dermatology 2018, 57, e30–e43 ª 2018 The International Society of Dermatology