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Eruptive pseudoangiomatosis (EP) is a rare, benign, spontaneously regressing exanthema characterized by an eruption of distinctive erythematous angioma-like papules that are often surrounded by a pale halo, as in other cases with facial localization [1]. Unlike an angioma, however, vascular ectasia without vascular proliferation is found at histology [2]. The etiopathological mechanism of EP remains unclear, but it seems to be correlated to viral infections such as echovirus, coxsackie, and adenovirus. EP can also appear a few minutes after insect bites, in particular mosquito or flea bites, and is also referred to as erythema punctatum Higuchi or purpura pulicosa. Mosquito bite reactions differ from one person to another, and this difference depends on the intensity of the immediate and delayed reactions in each individual. In this respect, repeated exposure to mosquito bites alters the bite reactions in humans. If the EP is a mosquito bite reaction, it should correspond to a stage V reaction (no immediate or delayed reaction) [1,3]. Differential diagnosis includes multiple eruptive capillary hemangiomas, all drug eruptions, and adrenergic urticaria. In addition, dermoscopy could be a useful tool for differential diagnosis with other common vascular lesions. Multiple eruptive capillary hemangiomas are characterized dermoscopically by reddish, well-demarcated, round or oval areas called lagoons or vascular lacunae. Pigmented purpuric dermatosis is typically characterized by a coppery red background, round-to-oval dots, gray dots, and a network of brownishto-gray interconnected lines; 4 specific patterns of pigmented purpuric dermatosis have been reported in the literature. Pyogenic granuloma, on the other hand, presents a reddish homogeneous area, white collarette, or white rail lines (even more so when associated together). Moreover, the onset of pyogenic granuloma is usually preceded by traumas or infections [4].

Eruptive Pseudoangiomatosis Induced by Mosquito Bites in an Infant