Idiopathic Atrophoderma of Pasini and Pierini: A Case Report and Literature Review

Abstract

Atrophoderma of Pasini and Pierini (APP) is a rare cutaneous condition of unknown etiology, predominantly affecting young women. It is a dermatologic disorder characterized by hyperpigmented depressed patches of dermal atrophy. Patients usually present with single or multiple asymptomatic, violaceous, and sharply demarcated areas of depressed plaques; of note, unlike morphea, there is no surrounding erythema or induration. In this report, we discuss a case of a 43-year-old South Asian male patient who presented with an eight-month history of multiple asymptomatic, and depressed bluish-brown plaques that had appeared over his body. The clinicopathological correlation was consistent with a diagnosis of idiopathic atrophoderma of Pasini and Pierini (IAPP). We also engage in a review of the literature on IAPP.

Keywords: atrophoderma; dermal atrophy; iapp; morphea; pasini and pierini.

Figure 1. Cutaneous patch of dermal atrophy on the dorsal aspect of the right hand with a pathognomonic “cliff drop”-like appearance (arrow)

Figure 2. Depressed hyperpigmented violaceous cutaneous patch on the dorsal aspect of the left hand with a “cigarette paper”-like appearance (arrow)

Figure 3. Small clustered hyperpigmented patches of dermal atrophy with a “moth-eaten” appearance on the lateral aspect of the right lower limb associated with minimal peripheral desquamation (arrows)

Figure 4. Multiple ovoid depressed cutaneous patches, brown in color and varying in size, noted on the medial aspect of the left thigh (arrows)

Figure 5. Histopathologic result of a punch biopsy taken from an atrophic plaque showing features of dermal atrophy with a hair follicle and sweat glands that are located in the reticular dermis