A 61-year-old woman with a 6-year history of diabetes mellitus, hepatitis C, and hypertension presented with skin disease of 2 years' duration. In 1994, she had developed pruritus and small, ivory-colored, shiny, round maculae scattered over her buttocks and submammary areas that later became atrophic. She underwent a biopsy and was treated with topical corticosteroids and oral antihistamines. Two years later, she developed indurated plaques on her lumbar and abdominal areas (Figure 1), with hemorrhagic bullae that gradually produced extensive superficial ulcerations when they ruptured. She subsequently noticed 2 patches of alopecia, atrophy, and ulceration on her scalp (Figure 2).There were no lesions involving the vulva or mouth. The findings of the rest of the physical examination were normal.
Gómez-Calcerrada MR, del Cerro Heredero M, Sánchez MH, Fernández RS, de Eusebio Murillo E, Yus ES. Bullous and Hemorrhagic Lesions. Arch Dermatol. 1999;135(1):81-86. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-1-dof0199