Lack of recurrence of malignant atrophic papulosis of Degos in multivisceral transplant: insights into possible pathogenesis?

A 30-year-old woman was referred to our unit because of the presence of erythematous papules that had initially appeared on her upper limbs 6 months previously. Her medical history included multiple operations for intestinal infarction and perforation and she was currently hospitalized after a complete ileal and jejunal resection. Her family history was unremarkable. On examination, she had several erythematous papules scattered over her body. The lesions were white to pink, measured less than 1.5 cm in diameter, and had a central, porcelain-white atrophic center surrounded by a peripheral telangiectatic rim (Fig 1). Histologic examination (Fig 2), including direct immunofluorescence that demonstrated C3 deposits on the vascular walls, confirmed our provisional diagnosis of malignant atrophic papulosis (MAP) of Degos.