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Pruritic Linear Eruption in a 53-Year-Old Woman: Challenge.

A 53-year-old woman presented with a 3-month history of a slightly pruritic, linear papulosquamous eruption on the posterior right thigh and buttock. Her medical history was significant for noninsulin-dependent diabetes, hypertension, and hypothyroidism. Cutaneous examination revealed a welldemarcated, pink scaly plaque with follicular prominence on the right buttock and a linear array of 1–3 mm pink scaly papules extending down the posterior thigh (Figs. 1A, B). A 3-mm punch biopsy was performed, and the hematoxylin–eosin–stained skin specimen showed parakeratosis and scale crust with irregular acanthosis and dyskeratotic keratinocytes at all levels of the epidermis. Spongiosis was also present and associated with exocytosis of lymphocytes (Figs. 2A, B). These same changes of dyskeratosis, spongiosis, and exocytosis were also appreciated within a hair follicle (Fig. 2C). A superficial perivascular infiltrate composed of lymphocytes was observed in the dermis. Vacuolar interface changes were minimal. Periodic acid–Schiff staining of the specimen was negative for fungal elements. Herpes simplex virus type 1, herpes simplex virus type 2, and varicella immunohistochemical staining was also negative.