Relapsing coalescent papular dermatosis of elderly patients: a precursor or an abortive lesion of Ofuji papuloerythroderma.

We describe a group of elderly patients (average: 71.1 year-old, 37 male and 6 female patients) with relapsing, coalescent, papular dermatosis. The skin rash started as intensely pruritic, discrete, solid papules developing in crops in a fairly localized area. The primary papular lesions tended to coalesce into flat-topped, polygonal papules or plaques that often showed a cobble stone-like appearance. The disease took a protracted course of repeated relapses without known precipitating factors. Both papular and coalescent plaque lesions showed compact perivascular infiltration of mononuclear cells containing varying populations of eosinophils in the upper dermis. Approximately half of the patients had mild hypereosinophilia and elevated serum IgE levels without histories of atopic diathesis. These clinicopathological features were consistent with those of the papular lesions that Ofuji originally defined as the primary skin rash of papuloerythroderma. We propose that our cases represent a precursor or an abortive lesion of Ofuji papuloerythroderma.