Brown-black eruptions

CASE #1

A 50-year-old black woman presented with several coin-shaped brown-black plaques that had first appeared on her lower legs two months before against a background of xerotic skin (asteatotic eczema). She suffered from hypertension, high cholesterol, and type 2 diabetes. Her current medications included atorvastatin (Lipitor), amlodipine (Norvasc), and glyburide (DiaBeta). The coin-shaped plaques had arisen in November. The patient reported pruritus, worse at night than during the day.

CASE #2

The patient was a 30-year-old black man who complained of brown-black plaques that had been present on his face and scalp for 10 years. Plaque areas on the scalp demonstrated a loss of hair follicles, i.e., a scarring alopecia. The patient was concerned about the development of new lesions, although none was developing currently. Biopsy confirmed the loss of hair follicles, epidermal atrophy, an interface dermatitis with lymphocytes, and dermal mucin. The patient had used 1% hydrocortisone without effect.

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