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A Case for Diagnosis: Poikiloderma? Presented by Dr. E. W. Netherton.
F. B., an unmarried white woman aged 29, presents an eruption of six years' duration. She has had Raynaud's disease since 1945.The eruption, starting on the lower portion of the abdomen as erythematous pruritic papules and papulovesicles, spread slowly to involve the entire torso, neck, arms and legs. As new lesions developed at the periphery of the eruption, the older lesions disappeared, leaving small round, depressed, thin scars with telangiectasia, as well as larger scars with central depigmentation and peripheral hyperpigmentation. Pruritus has been a distressing symptom.The eruption is strikingly symmetrical and multiform, consisting of large areas of light erythema, depigmented scars with areolas of hyperpigmentation, telangiectasia, irregular, slightly scaly erythematous plaques and groups of acuminate follicular papules with hyperkeratotic spines. In depigmented areas there are small zones of hyperpigmentation about the pilosebaceous follicles. On the