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December 15, 2008

Depressed Area on the Abdomen—Quiz Case

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Arch Dermatol. 2008;144(12):1651-1656. doi:10.1001/archderm.144.12.1651-c

A 6-year old Japanese boy presented with a 3-year history of a progressively enlarging asymptomatic area on his trunk. He had no previous or family history of a similar skin disorder.

Physical examination revealed a large, diffuse, well-demarcated, depressed area (15 × 28 cm) on the abdomen. Underlying blood vessels were visible through the skin, and the peripheral skin lesion was slightly erythematous (Figure 1). Inguinal lymph nodes were not enlarged. The findings of laboratory investigations, including peripheral blood, kidney, and liver functions, were within normal limits, and serologic tests were negative for antinuclear antibodies. Punch biopsy specimens were obtained from the periphery of the involved area (Figure 2 and Figure 3).