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.