A 22-year-old Asian woman complained of a pebbly plaque on the back of her neck. The patient reported that the area itched, but she rubbed it rather than scratch. The urge to rub was worst at night when she was lying in bed just before she went to sleep. During the day, while the patient was at work, she noted that the urge to rub was diminished. OTC hydrocortisone cream 1% did not help to alleviate the desire to rub or the pruritic nature of the eruption on her neck. No other areas of her body were particularly pruritic. The patient had no other medical problems.


A 28-year-old black man presented with a long history of flesh-colored (brown) papules coalescing to linear plaques on the nape of his neck. He had had this eruption in some form for more than 10 years. In recent years, hair had ceased to grow in the affected area, which was sometimes pruritic but never painful. The patient reported that his barber used a straight razor on the nape of his neck. There was no evidence of alopecia on any other
areas of the patient’s scalp. He did not have acne or pseudofolliculitis barbae.

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