Progressive reticular atrophy on the face

A 9 year old boy presented with a six year history of slowly progressive reticular atrophy, tiny papules, and open comedones on the right cheek (fig 1). He did not report any itching or pain and had received no treatment. A year previously, an atrophic patch with alopecia appeared on the right temporal area (fig 2). The parents reported no personal history or family history. A biopsy sample taken from the temporal lesions showed thinning of the epidermis and dermis, absence of hair follicles, and mild perivascular lymphocytic infiltration of the superficial dermis.bmj;384/mar07_1/e076981/F1F1f1Fig 1Reticular atrophy, tiny papules, and open comedones on right cheekbmj;384/mar07_1/e076981/F2F2f2Fig 2Atrophic patch with alopecia on right temporal areaQuestionsWhat are the differential diagnoses?What is the most likely diagnosis?How would you manage this condition?Answers1.What are the differential diagnoses?Differential diagnoses include atrophoderma vermiculatum, naevus comedonicus, and keratosis pilaris atrophicans faciei. Atrophoderma vermiculatum has a worm eaten appearance and presents as…
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