Pityriasis lichenoides et varioliformis acuta is characterized by the rapid onset of numerous reddish-brown macules and papules that usually evolve into vesicles, pustules, and crusted ulcers. The lesions have a polymorphous appearance, erupt in crops, and are distributed mainly on the trunk and extremities. The face, scalp, mucous membranes, palms, and soles are usually spared. Constitutional symptoms are uncommon. Lesions are usually asymptomatic and resolve in a few weeks to a few months. Rarely, there may be associated fever, malaise, headache, or pruritus.