Quiz Case

Lentigolike Macules and Erythematous Plaques on Trunk and Extremities

Figure 1.

Figure 2.

Figure 3.

A 60-year-old woman presented with an 8-year history of an asymptomatic progressive skin eruption on the trunk and extremities. The skin eruption was reported to be worse during the summer. The patient was otherwise healthy and receiving no drug therapy. Her family history was positive for similar skin condition in 2 sisters. Previous treatment with topical steroids was unsuccessful.

Physical examination revealed multiple erythematous and hyperpigmented tan macules and papules over the chest, upper extremities (mainly hands), bilateral thighs, and shins (Figure 1 and Figure 2). Some of the lesions were covered by discrete scales. No hair, nail, or mucosal abnormalities were present. A punch biopsy specimen was obtained (Figure 3).

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Ashish Bhatia, MD, Web Editor, Archives of Dermatology.