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Annular Atrophic Plaques on the Arms of a 57-Year-Old Woman—Quiz Case

Patrick J. Sniezek, MD; Arni Kristjansson, MD; Mary Seabury Stone, MD
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Michael E. Ming, MD

Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Dermatol. 2006;142(6):775-780. doi:10.1001/archderm.142.6.775-a
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REPORT OF A CASE

An otherwise healthy 57-year-old woman presented with several erythematous, annular lesions on her arms and legs. The lesions, which had gradually increased in size and number over the last 6 years, were occasionally pruritic. She had completed several courses of oral antifungal agents, which had been prescribed by her primary care physician, with no improvement. Her medical history was significant for a mild stroke that had occurred without any residual neurologic sequelae 2 months earlier. Her medications included clopidogrel and simvastatin, which she had begun taking shortly after her stroke. She denied having any systemic complaints.

Physical examination revealed a healthy-appearing, well-nourished woman in no acute distress. There were numerous 1- to 6-cm annular, atrophic plaques with elevated pink borders on her arms and legs (Figure 1). A biopsy specimen was obtained from the border of a lesion on her right arm (Figure 2 [hematoxylin-eosin] and Figure 3 [Verhoeff–van Gieson]).

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