Issue: 2020 > Juli > photo quiz

Red streaks arising from the periumbilical area in a mirror-like pattern

M. Puerta-Peña, J. Fulgencio-Barbarin, D. Falkenhain, P.L. Ortiz-Romero, V. Monsálvez-Honrubia
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A 50-year-old healthy woman with no prior dermatological history was referred to our department for evaluation of a 2-day history of burning erythematous plaques on the central part of her abdomen, arranged in an unusual shape. The patient had first noticed a red and intensely itchy papule in the umbilicus that was attributed to an arthropod bite, and within the first 24 hours, two linear skin lesions rapidly developed from the affected area. She denied any recent drug intake, travel history, local trauma, or contact with plants. Physical examination revealed an erythematous plaque around the umbilicus with well-defined borders. Examination also identified a central haemorrhagic punctum, associated with two erythematoedematous discontinuous linear streaks, arising from the periumbilical area and extending to the right groin and the left axilla in a mirror-like pattern (figure 1). No fever, lymph node enlargement, or other systemic symptoms were present and laboratory testing showed a normal blood cell count and no increasing of inflammatory parameters.


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