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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 Fall 2023 answers? Review them now. To submit cases and questions, email Dean Monti at dmonti@aad.org.

Diagnose this new case by Andrea Paola Caro Muñiz, MD, and Eduardo-Michelin Gomez, MD

A six-year-old female patient is seen at our outpatient clinics for evaluation of multiple scattered eczematous, scaly plaques overlying a hyperpigmented, hypertrichotic area extending from the patient’s left scapula down to her right dorsal hand (left image); the latter had been present since the patient was a one-year-old. Punch biopsy of the lesion revealed epidermal acanthosis with papillomatosis and hyperpigmentation of the basal layer, with numerous hairs in anagen stage. The patient was prescribed tacrolimus 0.1% ointment and triamcinolone acetonide 0.1% cream with significant improvement of the eczematous lesions (right image).

Illustration for Race for the Case Winter 2023

1. Which post-zygotic mutation has been associated with the development of this nevus?

2. Name the syndrome most commonly associated with this nevus.

3. What is the phenomenon observed in the image on the left?

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