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Lucio’s phenomenon after childbirth

receptor. The patient was examined thoroughly by chest x-ray, computed tomography scan, 18F-fluorodeoxyglucose positron emission tomography, upper and lower gastrointestinal endoscopy, cystoscopy, and ultrasound scan of the breasts. A blood test, including tests for tumor markers, carcinoembryonic antigen, and prostate specific antigen, was within normal range. These examinations revealed no other internal malignancy, including breast cancer. The findings led to the diagnosis of EMPD of both axillae. The patient underwent surgical excision with a 1 cm margin. As of 12 months post-surgery, there was no evidence of recurrence or new malignancy. Only 12 cases of APD have ever been reported, and these are all unilateral lesions. In our case, the lesions of both axillae had been treated with application of steroid or antifungal ointment for two years. Bilateral APD is difficult to diagnose due to its rarity. However, a detailed review of clinical features by our institution prompted a dermoscopic examination that led to the finding of a slightly depigmented area in the lesion (Fig. 2). Depigmented areas are known to accompany EMPD lesions. In conclusion, we propose clinical and dermoscopic characteristics that can assist in the diagnosis of bilateral APD: When a refractory eczematous lesion is found on the axilla, detailed dermoscopic examination is advised.