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JAMA Dermatology Clinicopathological Challenge
March 2018

Reticular Hyperpigmented Eruption in a Young Woman

Author Affiliations
  • 1Department of Dermatology, Mayo Clinic, Jacksonville, Florida
JAMA Dermatol. 2018;154(3):353-354. doi:10.1001/jamadermatol.2017.4693

A woman in her 20s was seen with a 6-year history of recurrent, pruritic skin eruptions involving the middle and lower back. Before evaluation in our department, the patient had undergone a skin biopsy that showed spongiotic dermatitis, had patch testing that was reportedly negative, and received a diagnosis of atopic dermatitis. She was treated with potent topical corticosteroids and oral prednisone, with no improvement. She denied use of heating pads, space heaters, or other forms of external radiation. Physical examination showed several discrete, erythematous, scaly papules admixed with light brown reticulated macules and patches (Figure, A and B). Punch biopsy specimens were obtained for further evaluation (Figure, C and D).

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