Dorene Niv

The Diagnosis: Superficial Acral FibromyxomaA shave biopsy revealed an uninvolved grenz zone and mildly cellular spindle cell dermal proliferation in a collagenous and myxoid background (Figure 1). Spindle cells were seen in a myxoid background among dense coarse collagen (Figure 2A). Spindle cells also were seen in a myxoid background with mast cells and capillary network (Figure 2B).

The Diagnosis: Corticosteroid-Induced HypopigmentationThis patient received several intralesional injections of triamcinolone acetonide once monthly for treatment of the keloid scar on the left ear at an outside institution. There was improvement in the size of the keloid over time. On physical examination during the most recent visit there was a prominent streak of hypopigmentation and atrophy near the corticosteroid injection site with extension to the postauricular region.

Circumscribed palmar hypokeratosis is a rare, benign, acquired dermatosis that was first described by Pérez et al1 in 2002 and is characterized by annular plaques with an atrophic center and hyperkeratotic edges.