Case for Diagnosis. Presented by Dr. Robert H. Grekin, Kalamazoo.
A 29-year-old white woman first developed some brownish spots on the upper thighs early in November, 1959. These spread over the pubic area and stayed about the same until mid-December, when she developed blue spots extensively on the trunk. The lesions were more noticeable when the skin was chilled but would vary in intensity without obvious reason. The patient had had infectious hepatitis in April, 1959, and had been exposed to arsenical sprays while picking fruit in the summer of 1959.Examination reveals hyperpigmented brownish macules up to a dime in size on the upper inner thighs, the pubic and axillary areas, and about the neck. On the anterior and posterior chest and on the arms, there are hypopigmented macular lesions with a faintly blue tinge.Laboratory examinations including the Thorn test and the serum protein electrophoresis were normal.Biopsy
Palmer AE, Grekin JN, Burns RE. DETROIT DERMATOLOGICAL SOCIETY. Arch Dermatol. 1961;83(2):327–329. doi:10.1001/archderm.1961.01580080157023
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