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March 1990

Rectangular Reticulate Patches on the Pretibial Areas

Author Affiliations

New York (NY) Veterans Administration Medical Center, and New York (NY) University School of Medicine

Arch Dermatol. 1990;126(3):387-388. doi:10.1001/archderm.1990.01670270119021

REPORT OF A CASE  A 72-year-old man presented with persistent dark brown discoloration of his lower legs. The lesions first appeared approximately 2 years before presentation, after the patient spent prolonged periods sitting by an open gas oven to keep warm during the winter. He first noted areas of erythema with accompanying burning and pruritus. The erythema initially resolved during the summer months. During the subsequent winter, on reexposure of the legs to heat from the oven, the lesions became persistent and progressed from red to dark brown.On physical examination, a dark-brown, reticulate patch with thick, greasy, yellow scale was noted on the pretibial surface of each leg. The scale could easily be rubbed off to reveal atrophy of the skin. The patches were sharply demarcated, symmetrical, and rectangular (Figs 1 and 2). A skin biopsy was performed. A representative section stained with hematoxylinphloxine-safranin is shown in Fig 3;

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