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Make the Diagnosis: A Young Woman With a White-ish Neck Rash: What’s Your Take?

MedpageToday

Presentation

A 32-year-old woman visited her doctor concerned about a rash that developed on her neck and chest 3 months prior. The patient was distressed by its appearance, and experienced mild pruritus, but appeared well and had no systemic symptoms. The patient had a medical history of alopecia areata and Hashimoto thyroiditis. On examination, numerous follicularly-based, whitish, smooth papules, some confluent, were seen on the upper chest and neck. Histopathologic examination showed epidermal atrophy, vacuolar degeneration at the dermal-epidermal junction, and homogenous hyalinization of the papillary dermis. The patient had no history of dermatological disease or allergies.


to use the Differential Builder in VisualDx to help you.

3% a) Anetoderma

7% b) Atrophoderma

15% c) Lichen planus

9% d) Lichen sclerosus

Learnings

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34 Votes