June 2005

Fig.1

Fig.2

History:
A 45-year old white female, with a past medical history significant only for rectal fissures in the 1980's, presented for evaluation of a plaque present for 5-6 years on the right temple (Figures 1-2). The lesion began as a small pink papule. However, throughout the years, it had noticeably been increasing in size. She denied any pruritus, pain, or other symptoms associated with the lesion. Moreover, she had no personal or family history of diabetes mellitus. She had two biopsies performed on the lesion in the past. She told us the first biopsy was consistent with a keratinous cyst, and the second biopsy demonstrated a non-specific dermatitis.

Pertinent Medications: Prempro

Physical Exam: Physical exam demonstrated a thin, white female. On the right temple, there was a 5.3 by 6.3 centimeter plaque, which had a pearly, yellow atrophic center that contained prominent telangiectasias. Surrounding the atrophic center, there was a palpable, red-brown border. There were no other similar plaques located anywhere else on her body.

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