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Year : 2007  |  Volume : 73  |  Issue : 1  |  Page : 66

Widespread induration of the skin


Department of Skin and STD, Kasturba Medical College, Manipal, India

Correspondence Address:
Vandana Mehta Rai
Department of Skin and STD, Kasturba Medical College, Manipal-576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.30666

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How to cite this article:
Rai VM, Balachandran C. Widespread induration of the skin. Indian J Dermatol Venereol Leprol 2007;73:66

How to cite this URL:
Rai VM, Balachandran C. Widespread induration of the skin. Indian J Dermatol Venereol Leprol [serial online] 2007 [cited 2020 Aug 8];73:66. Available from: http://www.ijdvl.com/text.asp?2007/73/1/66/30666


A 63-year-old male farmer presented with thickening and whitish discoloration of skin of the arms, forearms, upper chest and back of six months duration. Complaints started with itching over the right arm, which over a period of time became indurated. Skin tightness soon progressed to involve both upper limbs, chest and the back. At the same time the patient also gave history of multiple asymptomatic hypopigmented papules which coalesced to form atrophic plaques over the upper chest, forearms and back. There was no history of fever, joint pain, insect bites, circumcision, drug intake prior to the onset of lesions. There was no history of similar skin tightness over the face, hands or any other systemic complaints. Cutaneous examination revealed widespread induration of the skin of the upper back, chest, arms and both forearms. The skin of the right forearm appeared shiny because of induration [Figure - 1],[Figure - 2],[Figure - 3],[Figure - 4],[Figure - 5]. The lower limbs and face were not affected.

Multiple hypopigmented atrophic papules and plaques were seen on the back, chest and arms. Hypopigmented plaques with prominent follicular plugging were seen on the right arm. Palms, soles, nails and genitalia showed no abnormality. Systemic examination was normal. All the routine hematological and biochemical parameters were normal. The antinuclear antibody (ANA) profile showed a weak positive reaction to Sm and SS-A antibodies. Findings of the skin biopsy done from the indurated lesion on the right arm. A biopsy performed from the shiny lesion on the right forearm showed flattened epidermis with homogenization of the dermal collagen and a patchy perivascular infiltrate in the dermis.


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  References Top

1.Wallace HJ. Lichen sclerosus et atrophicus. Trans St Johns Hosp Derm Soc 1971;57:9-30.  Back to cited text no. 1  [PUBMED]  
2.Hart WR, Norris HJ, Helwig EB. Relation of lichen sclerosus et atrophicus of the vulva to development of carcinoma. Obstet Gynecol 1975;45:369-77.  Back to cited text no. 2  [PUBMED]  
3.Bainbridge DR, Whitaker RH, Shepheard BG. Balanitis xerotica obliterans and urinary obstruction. Br J Urol 1971;43:487-91.  Back to cited text no. 3  [PUBMED]  
4.Meffert JJ, Davis BM, Grimwood RE. Lichen sclerosus. J Am Acad Dermatol 1995;32:393-416.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Disilverio A, Serri F. Generalized bullous and haemorrhagic LSEA. Br J Dermatol 1975;93:215-7.  Back to cited text no. 5    
6.Mowas CM, Guzzo CA. A 14 year old girl with hyperkeratotic plaques. Dermatol Today 1994;4:2-5.  Back to cited text no. 6    
7.Borda JM, Abulafia J, Jaimovich L. Circumscribed sclero-atrophic syndrome. Arch Argent Dermatol 1967;17:89-119.  Back to cited text no. 7  [PUBMED]  
8.Pures J, Krull EA. Lichen sclerosus et atrophicus involving the palms. Arch Dermatol 1971;104:68-9.  Back to cited text no. 8    
9.Foulds IS. Lichen sclerosus et atrophicus of the scalp. Br J Dermatol 1980;103:197-200.  Back to cited text no. 9  [PUBMED]  
10.Helm KF, Gibson Le, Muller SA. Lichen sclerosus et atrophicus in children and young adults. Pediatr Dermatol 1991;8:97-101.  Back to cited text no. 10  [PUBMED]  
11.Ronnen M, Subster S, Kahana M, Schewach-Millet M. Bilaterat Koebner phenomenon in lichen sclerosus et atrophicus. Int J Dermatol 1987;26:117-8.  Back to cited text no. 11    
12.Patel RI, Reed WB. Annular atrophic plaques of the face and upper body. Cutis 1979;24:90-3.  Back to cited text no. 12  [PUBMED]  
13.Goodfield MJ, Jones SK, Veale DJ. The 'Connective Tissue Diseases'. In : Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 7th ed. Blackwell Science: Oxford; 2004. p. 56.1-56.147.  Back to cited text no. 13    


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[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]



 

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