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A 21-year-old African American female had pruritic lesions around her umbilicus for
8 years. Two months before presentation, she developed additional lesions on her chest
and ears. Treatment with topical hydrocortisone cream, 2.5%, resulted in no improvement.
Her past medical history was significant for asthma and seasonal allergies. On examination,
the patient had erythematous papules coalescing into scaly, lichenified plaques with
post-inflammatory hyperpigmentation on her earlobes, around her umbilicus, and on
her central chest (Figure 1, Figure 2, Figure 3).
Figure 1The patient had hyperpigmented, lichenified, papules and plaques in a periumbilical
distribution.
