Overlap between atrophoderma Pasini-Pierini and juvenile idiopathic arthritis

摘要

A 15-year-old boy presented with a 3-year history of a brownish atrophic plaque on the middle of his back. The skin lesion was initially seen as an egg-sized, light violaceous brown patch, which slowly enlarged in size and measured about 150 x 70 mm at presentation.On physical examination, the lesion showed features of dermal atrophy and was slightly depressed below the level of the normal surrounding skin, which had an irregular border of 'cliff-drop' appearance. The texture of the lesional skin was rather smooth (Fig. 1). Six months after first noticing the skin lesion, the patient had noted joint discomfort such as a mild degree of pain, swelling and stiffness. These symptoms had been occurring mainly in the small joints of the hands. Examination showed some swelling with synovial thickening in most of the proximal and interphalangeal joints of the patient's hands. The rest of the systemic examination was normal.