Derm Dx: Hypopigmented patch without sensation

A 35-year-old refugee from Bhutan, a country in South Asia, presents complaining of a hypopigmented skin patch on his right arm. He complains that the patch feels “dry” and that he has lost sensation within the patch.

On exam, he is a well-nourished, well-developed South Asian male. A complete physical exam is remarkable only for a hypopigmented patch on ...