Rare Presentation of Pityriasis Lichenoides et Varioliformis Acuta: A Case of Mucosal and Face Involvement in a 15-Year-Old Male.

Pityriasis lichenoides et varioliformis acuta (PLEVA) is a rare inflammatory skin disorder, and mucosal involvement is exceptionally uncommon. We present a 15-year-old male who developed PLEVA with facial and mucosal involvement, preceded by fever. Dermoscopy revealed dotted and linear vessels with micaceous scales. Histopathology showed focal parakeratosis, epidermal exocytosis of neutrophils and lymphocytes, and dense inflammatory infiltrates extending into the subcutaneous tissue. The patient responded well to doxycycline, achieving complete resolution, though varioliform scarring and hyperpigmentation remained. This case underscores the rarity of mucosal involvement in PLEVA and highlights the importance of early recognition and treatment to minimize long-term cutaneous damage.