Diagnosis: Poikiloderma Atrophicans Vasculare. Presented by Dr. S. M. Peck for Dr. Y. P. Kim.
The patient is a white woman, age 36.History of present illness: The lesions developed abruptly four years ago on the breast and at the same time over the abdomen, mostly on the flexor surfaces of the extremities. These were round, oval, irregular in configuration, sharply demarcated, brownish in color, macular, multiple, and asymptomatic.Physical examination: There are sharply defined, irregular, some geometrically round patches, brown in color, telangiectatic, hemosiderin-like to extravasation, slightly atrophic and depressed, various sized, dry, scaly, macular lesions over the abdominal region, breast, and inner surfaces of the thighs and arms without any particular recognizable subjective symptoms.Biopsy: skin segment compatible with poikiloderma atrophicans vasculare.Course and treatment: not treated.
Discussion
Dr. David Bloom: I had under observation a patient with similar lesions which, after about 16 years, started to become increasingly indurated.