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September 1996

Annular Lesions in a Black Woman

Author Affiliations

Vanderbilt University, Nashville, Tenn (Dr Boyd), and the University of Texas Medical School and the University of Texas M. D. Anderson Cancer Center, Houston (Dr Cohen)

Arch Dermatol. 1996;132(9):1109-1110. doi:10.1001/archderm.1996.03890330123023

REPORT OF A CASE  A 39-year-old black woman presented with pruritic papules and annular lesions over her trunk and extremities (Figure 1). The lesions were hyperpigmented and had a raised outer rim (Figure 2). There was a suggestion of atrophy in the center. Individual papules were 5 to 20 mm in diameter. The patient was taking no medications and had no concurrent illnesses. Her nails, hair, and mucosal surfaces were unremarkable. The results of a potassium hydroxide test were negative.Sections of a punch biopsy specimen from the edge of a lesion are shown in Figure 3 and Figure 4.What is your diagnosis?

DIAGNOSIS:  Annular lichen planus (LP).

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  The epidermis was hyperkeratotic and acanthotic. Parakeratosis and eosinophils were absent. There was an increase in the granular cell layer. "Sawtoothing" of the rete ridges was prominent. Vacuolar alteration

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