Erythrokeratodermia variabilis: Two case reports
A 15-year-old boy was admitted to our clinic for transient redness and brownish-crusty lesions. He had these lesions since age 2. He was seen by several physicians and he was treated with different treatments including salicylic acid, and corticosteroids that were ineffective. Erythematous lesions appeared from time to time that worsened with physical activities and heat, and disappeared spontaneously. However, the brownish crusty lesions did not recover. His parent was a second-degree relative. His sister had similar symptoms, but did not come to the clinic for an examination. The dermatological examination showed well-marginated, brownish hyperkeratotic lesions symmetrically distributed on the axillary regions, antecubital fossa, inguinal region, and lower extremities [Figure and ].\nNo fungal elements were detected in potassium hydroxide preparations in both patients. The laboratory tests including complete blood count, liver function tests, lipid profile, glucose, creatinine, serum urea nitrogen, calcium, phosphate, and urinalysis were within normal limits.\nThe histopathological assessments of hyperkeratotic lesion showed basket-like hyperkeratosis, papillomatosis, acanthosis, and perivascular lymphocytic infiltration of the dermiş []. The clinical and histopathological findings were consistent with EKV. Systemic therapy in case one was refused by the parents; so topical corticosteroid treatment was initiated. The second patient was treated with acitretin po (25 mg/d). The lesions were regressed with mild hyperkeratosis at the end of 4 months treatment. Then the patient discontinued the treatment. During the 1 year follow-up period, he occasionally had episodes of erythema and mild degree of hyperkeratosis.