Cribriform ulcerations of the back

Abstract

A 26-year-old woman presented with a 6-week history of cribriform back ulcers, some of which had central hyperkeratotic crusts (Fig 1), and atrophic hyperpigmented papules on the arms (Fig 2). Additionally, she had scarring alopecia (Fig 3) and livedo reticularis of both legs. Review of systems was positive for Raynaud phenomenon, photosensitivity, oral ulcers, and joint pain for many years. Skin biopsies from the back and the arm both found interface dermatitis, thickened collagen bundles, periadnexal inflammation, focal fat necrosis, and increased dermal mucin (Figs 4 and 5).