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JAMA Dermatology Clinicopathological Challenge
April 2018

Scattered Hypopigmented, Atrophic, and Folliculocentric Papules on the Trunk

Author Affiliations
  • 1Department of Dermatology, Cathay General Hospital, Taipei, Taiwan
  • 2Department of Dermatology, Cathay General Hospital, Hsinchu, Taiwan
JAMA Dermatol. 2018;154(4):469-470. doi:10.1001/jamadermatol.2017.5174

A woman in her 60s presented with numerous whitish papules on the back of more than 10 years’ duration. The lesions previously resolved with topical corticosteroids but flared soon after treatment discontinuation. Some papules became pruritic and extended to the waist and anterior trunk in the past month. No family history of similar lesions was recorded. Physical examination revealed multiple hypopigmented, flat-topped papules on the back, waist, and inframammary area without genital involvement (Figure, A). Most lesions were folliculocentric under close inspection. Dermoscopy revealed central keratin plugs and some foci of structureless, whitish, and homogenous areas with surrounding erythema (Figure, B). The results of laboratory tests for antinuclear antibody and hyperglobulinemia were negative. A biopsy specimen was obtained from the back for histologic analysis (Figure, C).

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