Does this hand lesion signal underlying disease?

January 11, 2011

Asymptomatic lesion on the dorsum of a 15-year-old boy’s left hand extends on to the first 2 fingers and has produced nail dystrophy. The patient is otherwise healthy and denies any history of trauma to the hand.


Case 2:
This asymptomatic lesion on the dorsum of a 15-year-old boy’s left hand extends on to the first 2 fingers and has produced nail dystrophy. The patient is otherwise healthy and denies any history of trauma to the hand.

(Answer on next page.)

 

Case 2: Linear scleroderma (linear morphea)

This patient had linear scleroderma, B, or linear morphea. These lesions may extend the entire length of the arm or leg. The childhood type of linear morphea may undergo spontaneous resolution. There is no FDA-approved treatment for this condition, although anecdotal reports describe numerous therapies that have been tried.

Linear lichen planus usually presents with purple papules that appear in a straight line after trauma. A linear epidermal nevus has a wart-like appearance. Raynaud phenomenon can affect the vascular supply, but it is associated with color changes when the skin is exposed to cold temperatures.