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October 1991

A Woman With Nodules and Depressed Scars

Author Affiliations

University of Genoa (Italy)

Arch Dermatol. 1991;127(10):1576. doi:10.1001/archderm.1991.01680090141022

REPORT OF A CASE  A 59-year-old woman presented with three areas of cicatricial alopecia on her scalp (Fig 1) and a painless deep nodule on her right arm (Fig 2). The skin overlying the nodule was erythematous, depressed, and atrophic. A 12-cm2-wide plaque was present on both breasts. Each plaque was well demarcated, movable, and covered by depressed and ulcerated skin.The nodule on her left arm and the lesions on her scalp that produced the cicatricial alopecia developed 20 years before; the nodules on her breast developed 15 years before.A biopsy specimen of the lesion on the arm showed a lymphocytic perivascular infiltrate in the deep dermis and subcutis with replacement of fat lobules by pale-stained hyalinized collagen (Figs 3 and 4). Direct immunofluorescence showed granular deposits of IgM and C3 in the dermal vessels and around the hair follicles. Direct immunofluorescence of uninvolved nonphotoexposed skin

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