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May 1997

Hypopigmented, Hyperkeratotic Macules in a Teenager

Author Affiliations

Indiana University School of Medicine, Indianapolis

Arch Dermatol. 1997;133(5):651-652. doi:10.1001/archderm.1997.03890410111017

REPORT OF A CASE  A 14-year-old girl presented with a 5-year history of light areas on the upper part of her arms and back and the lateral aspect of her cheeks. She stated that these areas were occasionally pruritic and that they appeared more prominent during the summer months. A brief trial of acyclovir was instituted, without resolution of the lesions. The patient denied any other skin problems. She reported a history of asthma but no other medical conditions.Physical examination revealed scattered 1- to 3-mm hypopigmented, hyperkeratotic macules. These were distributed across the lateral malar eminences, as well as across the upper part of the arms and back (Figure 1 and Figure 2). Several of the macules were atrophic with central hyperkeratotic dells. A 3-mm punch biopsy specimen was taken from the upper part of the right arm (Figure 3 and Figure 4).What is your diagnosis?

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