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JAMA Dermatology Clinicopathological Challenge
April 25, 2018

A Man With Infiltrated Plaques on the Pretibial Area

Author Affiliations
  • 1Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 2Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
JAMA Dermatol. Published online April 25, 2018. doi:10.1001/jamadermatol.2017.6449

A man in his late 20s presented with mildly itchy, erythematous plaques of 3 months’ duration on both legs. The lesions started to appear on the left pretibial region as small papules, which gradually increased in size and coalesced to form bigger plaques. No history of local trauma, prolonged standing, and occupational exposure to mineral dust or recent drug intake was recollected. He was not diabetic. On examination, large, ill-defined, erythematous plaques were present on the pretibial areas extending onto the lateral aspect of both legs. The plaques were surmounted by multiple, discrete atrophic scars. The periphery of the plaques showed increased vascularity in the form of telangiectasias and venous prominences, along with atrophy of the overlying skin (Figure, A). There were no lesions elsewhere on the body. A skin biopsy sample was obtained from the plaque and sent for histopathological examination (Figure, B and C).

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