Case 1

A 40-year-old woman presents to the dermatology clinic for evaluation of a dark rash on her shin. She reports that she has had the rash for 3 years and describes it as extremely itchy and spreading. Physical examination shows hyperpigmented papules that are approximately 1- to 3-mm in diameter on the pretibial region of the patient’s leg. She reports no other medical problems, no relevant family history, and no systemic symptoms, and she takes no medications. Histologic examination with Congo red staining reveals eosinophilic infiltrate in the papillary dermis, with apple green birefringence.

Can you diagnose the condition in Case 1?

A. Prurigo nodularis
B. Postinflammatory hyperpigmentation
C. Lichen amyloidosis
D. Colloid milium

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