Figure 1.

Lesions of idiopathic guttate hypomelanosis and extragenital lichen sclerosus atrophicus over the forearm of a 45-year-old woman. (A) Clinical picture of multiple discrete “confetti” hypopigmented macules over the forearm that made the patient anxious that she was suffering from vitiligo or leprosy. (B) Dermoscopy confirming the diagnosis of idiopathic guttate hypomelanosis with concomitant evolving lesions of extragenital lichen sclerosus atrophicus. Ameboid and nebuloid variants of idiopathic guttate hypomelanosis arranged in a “cloudy sky” pattern. Additionally, note the scattered white structureless areas with comedo-like plugs typical of lichen sclerosus atrophicus. Dermoscopy-guided biopsy of 2 lesions confirmed dermoscopic diagnosis. (Escope video dermatoscope, Timpac Healthcare Pvt. Ltd., New Delhi, India; ×20.) [Copyright: ©2019 Sonthalia et al.]