A 32-year-old man was seen in January 1997 for a skin eruption which had appeared 2 months earlier. He was in good health and was not taking any drugs. He had not left town and denied any other symptom except a short, flu- like episode 2 months earlier. On examination, he showed multiple, papular, scaly and necrotic lesions over the trunk, arms (Fig. 1), and thighs. The face and the mucosae were spared. No lymphadenopathy was evident, and the liver and spleen were not palpable. Routine laboratory tests were insignificant. Histopathology of a papular lesion of the arm showed a thick scaly crust overlying a necrotic epidermis and a lichenoid infiltrate of lymphocytes and neutrophils (Fig. 2). Extravasation of red blood cells and endothelial swelling of the small superficial vessels were also present. A diagnosis of subacute pityriasis lichenoides (PL) was made, and treatment with 500 mg/day azithromycin, 3 days a week for 1 month, was prescribed without any benefit. Enzyme-linked immunosorbent assay (ELISA) for Toxoplasma gondii showed immunoglobulin G (IgG) 150 (n.v.
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