To the Editor： A 23-year-old otherwise healthy male presented with diffuse, erythematous, nonpruritic papules on the trunk and extremities, which gradually developed over 1 month Figure 1a and 1b. The patient was afebrile and had no other systemic symptoms. His personal and family histories were unremarkable. He denied any drug intake or episode of infection before the onset. Head, hands, feet, and mucosa were spared. No lymphadenopathies were detected. Histopathological examination revealed full-thickness epidermal necrosis, parakeratosis, vacuolization of the basal layer, and superficial perivascular infiltration of lymphocytes and histiocytes in the dermis. Exocytosis was prominent, and intraepidermal red blood cells could be seen Figure 1c. A diagnosis ofpityriasis licbenoides et varioliformis acuta （PLEVA） was established. He was prescribed with oral prednisolone （30mg/d） for 2 weeks, and complete remission was obtained. A follow-up visit at 3 years later showed no evidence of recurrence of PLEVA.