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JAMA Clinical Challenge
Clinician's Corner
January 23/30, 2013

Hypopigmented Patches on the Skin

Author Affiliations

JAMA Clinical Challenge Section Editor: Huan J. Chang, MD, Contributing Editor. We encourage authors to submit papers for consideration as a JAMA Clinical Challenge. Please contact Dr Chang at tina.chang@jamanetwork.org

Author Affiliations: Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.

JAMA. 2013;309(4):392-393. doi:10.1001/jama.2012.211717

A 47-year-old man presents with a 1-year history of a mildly pruritic eruption on the trunk and extremities. He has no significant medical history and takes no medications. He denies any recent travel or close contact with persons or animals having a similar eruption. Review of systems is negative. On physical examination, he has hypopigmented round patches with fine cigarette-paper scaling centrally located on his proximal arms, hips, thighs, lateral chest wall, and flanks (Figure 1). Sensation is intact over the affected skin. Examination of skin scrapings using potassium hydroxide is negative for hyphae, and there is no palpable lymphadenopathy.