REPORT OF A CASE
A 28-year-old woman complained of unsightly brown spots that had been gradually progressive over the last five years. While she was mainly concerned with cosmetic appearance, she had noted episodes of pruritus that were unresponsive to antihistamine therapy. She was otherwise healthy, except for a history of mild acne, and there was no family history of similar skin lesions.
Physical examination revealed multiple 2- to 4-mm brown, oval macules scattered symmetrically about her neck, axillae, antecubital fossae, and groin regions (Fig 1). A lacelike configuration of pigment was more apparent in the axillary vault and crural folds. Slight wrinkling and shininess of the epidermis was noted in some areas, while others were mildly hyperkeratotic. She had grade I facial acne, with a few pitted perioral scars.
A skin biopsy specimen from the left axillary vault is shown in Figs 2 and 3. Histopathologic examination of the
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