An Ancient Malady

摘要

A 34-year-old black woman, recently arrived from the Democratic Republic of Congo, had a 9-month history of white patches on her body. Gradually enlarging and cosmetically disfiguring, these were accompanied by painful arm cramps. She had no other symptoms, had no relevant past medical history, and was on no medications.Several hypopigmented patches with reduced hair density and well-defined borders were distributed asymmetrically on the patient's limbs and back (Figures 1 and 2). None were completely devoid of melanin pigment. Through an interpreter, she reported that she no longer felt pain, crude touch, and temperature within the hypopigmented areas. Thickened nerves were not palpable. The patient was HIV-negative