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JAMA Dermatology Clinicopathological Challenge
June 9, 2021

Pruritic Lichenified Plaques on the Legs of a Man

Author Affiliations
  • 1Department of Dermatology, Hospital Universitario Doctor Peset, Valencia, Spain
  • 2Department of Pathology, Hospital Universitario Doctor Peset, Valencia, Spain
JAMA Dermatol. Published online June 9, 2021. doi:10.1001/jamadermatol.2021.1785

A man in his 50s presented with a history of pruritic lesions of the lower legs over the past 15 years that were unresponsive to topical corticosteroid therapy. On examination, he had multiple lichenified and ulcerated papules and nodules, some of them grouped in plaques located on the medial aspect of both shins (Figure, A). Occasional tense blisters were also seen (Figure, B). The patient’s family history was significant for similar cutaneous lesions in his father, brother, and cousin. Mild toenail dystrophy was also observed. A punch biopsy from the shin for histopathologic examination was performed (Figure, C and D).

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