History
The atrophic-appearing macules and plaques usually appear insidiously and asymptomatically on the back of the neck. The appearance of the initial lesions, which tend to be hypopigmented and depressed, may resemble vitiligo.
The eruption slowly encircles the neck and gradually spreads to the scapular and chest region, involving the intermammary area. In some instances, pseudoatrophic plaques continue to spread over the trunk and occasionally appear in other regions, such as the buttocks, the arms, and the lower part of the abdomen.
The disease tends to spread gradually with partial regression and intervals, persisting for years or decades.
Spontaneous regression has been described in one patient.
Usually asymptomatic, it occasionally causes mild pruritus.
Physical Examination
Individual atrophic-appearing plaques and macules are 3-7 mm in diameter, oval or irregular, white or pink, and some coalesce in arcuate patches. The surface of the plaques may be shiny or wrinkled and may show some scaling. The lesions may form a dappled pattern of hypopigmented and hyperpigmented areas.
The eruption is ill defined, and the pseudoatrophic plaques tend to be arranged in a vertical direction. The pseudoatrophic plaques are most often situated on the neck and the upper part of the thorax.
