Case Report:
A 30-year-old male patient with a four-year history of kidney transplantation and a history of a drug reaction to amphotericin B he received for a visceral leishmaniasis, presented for a recurrence of the cutaneous eruption, evolving for the last 6 months. He was under post-transplant maintenance immunosuppressive therapy including prednisone, Mycofenolate mofetil and azathioprine. Physical examination revealed multiple erythematous and confluent macules and papules of the torso and abdomen (Fig.1a,b,c). No verrucous lesions or tinea versicolor-like lesions were found. A skin biopsy of the macules was performed. Histological examination showed, in the upper epidermis, foci of keratinocytes of increased size, with enlarged nuclei and a bubbly, bluish, abundant cytoplasm, containing variably sized keratohyaline granules (Fig. 2). There were no signs of drug reaction. Histological features were consistent with the diagnosis of acquired EV. There was no history of affected relatives. A regular sunscreen application and close follow-up were proposed.