Atrophie blanche is not a disease but a symptom of different disorders. It can develop as such or be preceded by small, usually painful ulcers that heal slowly. Telangiectasia may be an associated reature.
The underlying pathologic change is represented by partial or complete occlusion of some dermal blood vessels; this is a result of fibrinous, or fibrinoid, deposit and/or on occasion intimal proliferation.
Lesions of atrophie blanche are more likely to occur at sites that have a relatively poor blood flow. One patient had essential cryoglobulinemia in whom atrophie blanche with ulcerations was the main clinical feature. Three others had systemic lupus erythematosus, scleroderma, and lymphoma, respectively, with atrophie blanche as an accompanying feature.
Stevanović DV. Atrophie BlancheA Sign of Dermal Blood Occlusion. Arch Dermatol. 1974;109(6):858-862. doi:10.1001/archderm.1974.01630060036009