A case of pityriasis rosea of vidal accompanied by neurofibromatosis type 1

A 23-year-old woman came to our outpatient clinic with a two-weeks history of pruritic reddish lesions on her armpits and groins. Her past medical history was consistent with neurofibromatosis type 1 (NF-1), for which she was under routine follow-up. Upon dermatological examination we observed multiple erythematous to violaceous coalescent and infiltrative plaques with central clearing which were annular and polycyclic in shape on bilateral proximal femoral regions (Figs 1-3) and erythematous papules tending to merge into smaller plaques on left axillary area (Fig. 4). Dermatological examination also disclosed several café-au-lait macules, one of which was greatest in diameter on left lateral brachial region and axillary freckling which was more marked on the left side (Fig. 4). A lesional skin biopsy from erythematous plaques revealed extravasation of red blood cells in dermis, dermal perivascular lymphocytic infiltration and focal spongiosis in the epidermis (Figs 5-7). Based on history, clinical and histopathological findings a diagnosis of pityriasis rosea circinata et marginata of Vidal (PRV) accompanied by NF-1 was made. The patient was prescribed topical corticosteroids and at the one month follow up visit, the lesions were significantly improved.