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White macules on the limbs of a 24-year-old man
White macules on the limbs of a 24-year-old man Yu-Ting Lin, MBBS, BSc (Med), and Ying-Yi Chiang, MD Taipei, Taiwan
A 24-year-old man with no notable medical history presented with a 3-year history of white spots on his limbs. The physical examination revealed diffuse irregular white macules interspersed with blanching erythematous macules, resulting in a reticulated appearance on his forearms and legs (Fig 1). The lesions were asymptomatic. His family history was noncontributory. There was no aggravating or relieving factor. Examination with a Wood’s light was unremarkable. Figure 2 shows the patient after he was asked to raise his arms for 10 minutes. 1.
What is the most likely diagnosis? A. Livedo reticularis B. Pityriasis alba C. Livedo racemosa D. Bier spots E. Nevus depigmentosus
2.
What is the definitive investigation for this patient? A. Antiphospholipid antibody B. Platelet level C. Blood test for cryoglobulinemia D. Antinuclear antibody E. None
3.
What is the most appropriate first-line treatment of his condition? A. Topical steroids B. Phototherapy C. Hydroxychloroquine D. Warfarin E. Observation Please visit http://www.eblueimages.org to answer these questions.
From the Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taiwan. Funding sources: None. Conflicts of interest: None declared. Reprint requests: Ying-Yi Chiang, MD, Department of Dermatology, Taipei Medical University Hospital, Taipei Medical University, Taiwan, Republic of China, No 111, Sec 3, Hsing-Long Rd, Taipei 11696, Taiwan. Email: [email protected].
J Am Acad Dermatol 2013;68:e109. 0190-9622/$36.00 ª 2012 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2012.09.003
e109
A 24-year-old man with no notable medical history presented with a 3-year history of white spots on his limbs. The physical examination revealed diffuse irregular white macules interspersed with blanching erythematous macules, resulting in a reticulated appearance on his forearms and legs (Fig 1). The lesions were asymptomatic. His family history was noncontributory. There was no aggravating or relieving factor. Examination with a Wood’s light was unremarkable. Figure 2 shows the patient after he was asked to raise his arms for 10 minutes. 1.
What is the most likely diagnosis? A. Livedo reticularis B. Pityriasis alba C. Livedo racemosa D. Bier spots E. Nevus depigmentosus
2.
What is the definitive investigation for this patient? A. Antiphospholipid antibody B. Platelet level C. Blood test for cryoglobulinemia D. Antinuclear antibody E. None
3.
What is the most appropriate first-line treatment of his condition? A. Topical steroids B. Phototherapy C. Hydroxychloroquine D. Warfarin E. Observation Please visit http://www.eblueimages.org to answer these questions.
From the Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taiwan. Funding sources: None. Conflicts of interest: None declared. Reprint requests: Ying-Yi Chiang, MD, Department of Dermatology, Taipei Medical University Hospital, Taipei Medical University, Taiwan, Republic of China, No 111, Sec 3, Hsing-Long Rd, Taipei 11696, Taiwan. Email: [email protected].
J Am Acad Dermatol 2013;68:e109. 0190-9622/$36.00 ª 2012 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2012.09.003
e109