Leg lesions and velvety hyperpigmentation on the neck

Jennifer Clay Cather, MD, and M. Alan Menter, MD

From the Division of Dermatology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas.

Corresponding author: Jennifer Clay Cather, MD, 5310 Harvest Hill Road, Suite 260, Dallas, Texas 75230.

An obese 35-year-old woman presented with an asymptomatic “rash” on the side of her neck of 3 years' duration. Despite vigorous cleansing and use of bleaching creams, the discoloration remained unchanged. In addition, the patient had noted “sores” on her leg over the preceding year that were unresponsive to topical antibiotics. On examination, well-circumscribed yellowish atrophic patches were noted on her shins, and a velvety, brownish discoloration was present on the sides of her neck.

What is the diagnosis and treatment?

(BUMC Proceedings 2002;15:327-328)