Erythematous papules with a white atrophic center are pathognomonic of Degos disease and reflect a specific histologic image of wedge-shaped necrosis. Herein we provide an RCM description of Degos disease skin lesions. In the central atrophic regions of the papules, we found a reproducible pattern of dermal necrosis with collagen densification and loss of dermal capillaries. These RCM features correlated closely with the underlying histologic changes. In addition, RCM disclosed that the telangiectatic ring, previously characterized as a crown of thorns in dermoscopy,3 corresponded to increased and dilated dermal capillaries, a new finding that was confirmed by histologic analysis and, to our knowledge, not described previously.4 In conclusion, as with the clinical and pathologic presentations, the RCM features associated with cutaneous lesions of Degos disease seem to exhibit very distinctive RCM features.