Race for the Case

Race for the Case is a clinical quiz feature published quarterly in DermWorld Directions in Residency — and right here!

Answer the questions below to enter. Looking for the Summer 2022 answers? Review them now.

Diagnose this case by Hesham Alshaikh, MD, and Alison Bailey, MD

A 50-year-old female presented to the dermatology clinic with a 3-week history of two growing “bumps” on the midchest. She has no similar lesions elsewhere and no prior treatments attempted. No personal or family history of autoimmune disorders. A review of symptoms was negative, specifically for vulvar pruritus and dyspareunia. However, she did note that her gynecologist recommended starting hydrocortisone for an asymptomatic rash in her groin. Physical examination revealed two circinate atrophic ivory-colored papules with an erythematous rim and follicular plugging. Punch biopsy for H&E confirmed the suspected diagnosis.

1. What is your diagnosis and name the most common locations affected in this disease?

2. Name the antibody associated with this disease and the genodermatoses that share a genetic mutation in the same protein?

3. What are the characteristic findings on H&E?

4. Name several conditions that can be associated with this disorder?

5. What is the first-line treatment for active localized disease? Mention two other treatment modalities?

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