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Linear lesions on the leg of a 13-year-old female patient

A 13-year-old female presents with multiple linear, thickened, and hypopigmented lesions on the lateral side of her left leg, extending from above the knee to just below the ankle. The lesions range from 2 cm to 30 cm in diameter, appear indurated, and feel hardened to the touch. She reports that the lesions first appeared 18 months ago on the distal left calf as small, red patches of skin with some inflammation. Since then, the lesions have changed color and spread in a band-like pattern to their current presentation of patchy white lesions with thickened skin in the center and hyperpigmentation on the edges. The patient says the lesions are not painful, but the underlying muscle and subcutaneous tissue feel hard and taut around the areas affected by the lesions. She has no other systemic complaints. The patient is still growing, and there is no disparity in the length of her limbs. She has a family history of lupus erythematosus, and her mother was diagnosed with the autoimmune disorder 10 years ago as an adult. The patient has mild facial acne but no other cutaneous symptoms or signs of inflammation.

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*Expert author(s), speaker(s) or contributor(s) where indicated are paid Galderma consultants.

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