Telangiectasia macularis eruptiva perstans

QUESTION 55

A 56-year-old man presents to the dermatology clinic for a routine skin check. On examination, there are small erythematous telangiectatic macules ranging in size from 3 to 10 mm distributed on the face, shoulders, upper arms and back (55a). With friction, the areas become slightly papular. There is no palpable lymphadenopathy or hepatosplenomegaly. He denies any fever, chills, abdominal pain or other skin concerns. Upon further questioning, the patient states that the symptoms have been evolving over the past 2 years. A skin biopsy was performed, which revealed a mononuclear infiltrate consisting of mast cells surrounding the capillaries of the superficial dermis. All laboratory work-up including a peripheral blood smear are within normal limits.