Schneiderman Prelims Vol-I. qxd

ATROPHIC LESIONS
AUTOIMMUNE DISEASES, AND DISEASES
OF IMMUNE DYSFUNCTION
Common variable immunodeficiency (Gottron-like papules) –
granulomas presenting as acral red papules and plaques
with central scaling, scarring, atrophy, ulceration 
Cutis
52:221–222, 1993
Dermatomyositis – panniculitis; nodules and plaques on
arms, thighs, buttocks, abdomen with lipoatrophy
AD 127:1846–1847, 1991; JAAD 23:127–128, 1990;
association with hypocomplementemia (C3 nephritic factor)
NEJM 294:461–465, 1976; associated with partial lipodystrophy
JAAD 28:348–351, 1993; asymmetric lipoatrophy
JAAD 22:966–969, 1990; longstanding dermatomyositis –
lipodystrophy-like appearance (hirsutism, loss of subcutaneous
fat, acanthosis nigricans); lipoatrophy in juvenile
dermatomyositis 
JAAD 22:966–969, 1990
Epidermolysis bullosa acquisita 
JAAD 24:706–714, 1991;
extensive scarring and mutilation in EBA 
AD 131:590–595, 1995
Graft vs. host disease, chronic – atrophic plaques 
JAAD
38:369–392, 1998; anetoderma AD 138:924–934, 2002
Lupus erythematosus – discoid lupus erythematosus 
Rook
p.2444–2449, 1998, Sixth Edition; NEJM 269:1155–1161, 1963;
DLE with spindly atrophy of fingers with hyperextension of distal
phalanges 
Rook p.2448, 1998, Sixth Edition; lupus panniculitis
(lupus profundus) – atrophic scarring 
J Cutan Pathol
28:235–247, 2001; Lupus 10:514–516, 2001; J Rheumatol
26:68–72, 1999; AD 103:231–242, 1971; lupus profundus with
secondary anetoderma 
Rook p.2451, 1998, Sixth Edition;
neonatal lupus 
Ped Derm 15:38–42, 1998; generalized
elastolysis with SLE 
JAAD 8:869–873, 1983; nodular cutaneous
lupus mucinosis – atrophie blanche-like lesions 
J Dermatol
21:674–679, 1994; secondary anetoderma with SLE, DLE, or
lupus profundus 
Ann DV 115:679–685, 1988; partial
lipodystrophy – association with hypocomplementemia (C3
nephritic factor) 
NEJM 294:461–465, 1976; tumid lupus (lupus
erythematosus telangiectoides) – reticulate telangiectasias of
face, neck ears, hands, breasts, heels, sides of feet; punctate
atrophy 
JAAD 41:250–253, 1999; Rook p.2447, 1998, Sixth
Edition; discoid lupus with annular atrophic plaques of face,
neck, behind ears 
AD 112:1143–1145, 1976; neonatal lupus
Ped Derm 22:240–242, 2005
Mixed connective tissue disease
Morphea – subcutaneous morphea leading to deep
atrophy 
Rook p.2504, 1998, Sixth Edition; linear (en coup
de sabre) 
Rook p.2505–2506, 1998, Sixth Edition; generalized
morphea 
Rook p.2511, 1998, Sixth Edition; pansclerotic
morphea – marked decrease of subcutaneous fat; reduced
acral bone density 
Ped Derm 19:151–154, 2002
Rheumatoid arthritis – generalized thinning of skin (transparent
skin) 
JAAD 53:191–209, 2005; Rook p.2004,2006, 1998, Sixth
Edition; Am J Med 54:445–452, 1973; Ann Rheum Dis
24:219–223, 1965
Scleroderma – atrophy of skin of face, hands; sclerodactyly
with tapered fingers; atrophy of terminal phalanges 
Rook
p.2528, 1998, Sixth Edition; pitted scars of finger tips (acral
pits), ulnar border of thumb, radial borders of second and third
fingers, dorsal fingers over joints; sclerosis with atrophic
phalanges; mandibular atrophy 
Dermatology 187:104–108,
1993; atrophie blanche around ankles