pseudoatrophoderma colli

Etiology

• idiopathic
  • vitamin A deficiency may be a contributing factor
  • may be a form of parapsoriasis

Epidemiology

• rare, 10-20 reported cases
• female predominance, all but 1 reported case in females
• reported cases 14-45 years

Pathology

• benign disease
• no associated mortality or morbidity.
• skin biopsy
  • hyperkeratosis of the epidermis
  • occasional parakeratosis
  • thinning of the granular layer
  • pacanthosis of some areas
  • vacuolation & pyknosis of prickle cells
  • minimal perivascular lymphocytic infiltration in the dermis
  • fragmentation of elastic tissue has been described
  • may be helful distinguishin from
    • atrophic lichen planus, lichen sclerosus, poikiloderma, or porokeratosis

Genetics

• autosomal dominant

Clinical manifestations

• pigmented macules & plaques with a wrinkled atrophic appearance
  • plaques & macules are 3-7 mm in diameter, oval or irregular, white or pink
  • some lesions coalesce in arcuate patches
  • plaques may be shiny or wrinkled & may show some scaling
  • lesions may contain hypopigmented & hyperpigmented areas
• distribution: neck & upper part of trunk
  • usually 1st appears on back of neck, gradually circles the neck & spreads to trunk
• spread is gradual with partial regressions
• lesions persist for years or decades.
• generally asymptomatic but may be associated with pruritus

Laboratory

• none indicated

Differential diagnosis

• acanthosis nigricans
• confluent & reticulated papillomatosis
• ichthyosis vulgaris
• lichen planus
• lichen sclerosus
• poikiloderma of Civatte
• porokeratosis
• Tinea versicolor
• vitiligo

Management

• prognosis
  • spontaneous clearing in 1 patient

More general terms

• skin disease (dermatologic disorder, dermatopathy, dermatosis)