Linear atrophoderma of Moulin

CASE REPORT A 22-year-old Malay woman presented with an 11-year history of asymptomatic, unilateral brown patches affecting the right arm, right side of the trunk, and right leg. There were no prior skin lesions or inflammation. There was no significant medical or family history. Physical examination found linear hyperpigmented atrophic patches on the right arm, right trunk extending down to the right buttock, right thigh, and right leg following Blaschko’s lines involving both anterior and posterior aspects (Fig 1, A). The skin was slightly atrophic on palpation. No signs of induration or inflammation were noted (Fig 1, B). Laboratory investigations including full blood count, erythrocyte sedimentation rate, renal profile, liver function test, antinuclear antibodies, doublestranded antinuclear DNA antibodies, antieSCL-70 antibody, anti-SSA(Ro), anti-SSB(La), antieJo-1, and anti-RNP antibodies were all negative or within the normal range. The first skin biopsy from a hyperpigmented patch over the right arm found mild upper dermal perivascular lymphocytic infiltrate. No dermal sclerosis was seen. Skin biopsy was repeated from normal skin (Fig 2, A) and from the hyperpigmented patch (Fig 2, B) on the right arm. Histopathologic examination of the affected skin found a mild upper dermal perivascular lymphocytic infiltration. When compared with the adjacent normal skin, the dermal thickness was reduced and the dermal collagen appeared more compact. The sweat glands,