[Hyperthermic ulcero-necrotic parapsoriasis "en gouttes" with naso-pharyngeal lesions]

The clinical history of a patient affected by a chronic relapsing eruption is presented. Successive papulopustular, necrotic and ulcerous lesions with fever and general distress appeared. There was no visceral affectation. The case corresponded to the necrotic and hyperthermic parapsoriasis "en gouttes" or acute pityriasis lichenoides as described by Degos and col., 1966. The presence of vasculitis with lymphohistiocytic inflammation invading the epidermis is described. The aspect was similar to the parapsoriasis "en gouttes" pattern even though a biopsy showed the presence of necrotizing angeitis of small vessels, as previously reported. The patient also presented oral and nasopharyngeal ulcerous lesions similar to those found in malignant midline granuloma and Wegener granulomatosis, even though histopathologically different. It is interesting to note the absence of any visceral involvement in a 12 years evolution.