PMC9149346_01
Patient at time of drug eruption. a The pinna with violaceous hypopigmented patches. b Hypopigmented patches with significant central hyperpigmentation on the posterior neck.
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F1
On physical examination, violaceous hypopigmented infiltrated plaques were seen on the pinna bilaterally, in the conchal bowl (Fig. 1), and on the neck (Fig. 2).
Patient 3 months after initial drug eruption. a Improvement of violaceous hypopigmented patches on the pinna. b Clearing of central hyperpigmentation on the posterior neck patches. c Hypopigmented patches on the forearms and dorsal hands.
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F2
At a follow-up visit 1 month later, there was notable clearing of the pinna and posterior neck; however, patches of hypopigmentation on the forearms and dorsal hands remained (Fig. 2).
Image under 20 magnification of H and E showing lichenoid infiltrate and neutrophils in stratum corneum with thin elongated rete ridges.
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F3
Skin biopsy demonstrated lichenoid interface inflammation with numerous dyskeratotic keratinocytes, pigment incontinence, parakeratosis, follicular plugging, and a dermal perivascular lymphocytic infiltrate (Fig. 3, 4).
Images under 10 magnification of H and E showing hyperkeratosis and follicular plugging.
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F4
Skin biopsy demonstrated lichenoid interface inflammation with numerous dyskeratotic keratinocytes, pigment incontinence, parakeratosis, follicular plugging, and a dermal perivascular lymphocytic infiltrate (Fig. 3, 4).