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JAMA Clinical Challenge

Hypopigmented Patches on the Skin

Image of hypopigmented patches with fine scale on the right upper thigh

Elizabeth Juhas, MD
Joseph C. English III, MD
A 47-year-old man presents with a 1-year history of a mildly pruritic eruption on the trunk and extremities. He has no significant medical history and takes no medications. He denies any recent travel, pets, or close personal contacts with a similar eruption. Review of systems is negative. On physical examination, he has hypopigmented round patches with fine cigarette-paper scaling centrally located on his proximal arms, hips, thighs, lateral chest wall, and flanks (Figure). Sensation is intact over affected skin. Potassium hydroxide examination of skin scrapings is negative for hyphae, and there is no palpable lymphadenopathy.

See the full article for an explanation and discussion.

Author Affiliations: Drs Enlgish (englishjc@upmc.edu) and Juhas are affiliated with the Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.