He is quite self conscious due to the appearance.

OE: brown color non scaly. Non blanchy.
Distribution lines of Blaschko

Biopsy result

CLINICAL NOTES:

Right hip rash appeared first on thigh right then spreads to right

lower abdomen, non the blanchy non scaly, 4 of the lines of Blaschko

DDX lichen striatus, incontinentia pigmenti (unlikely, as male), digitate dermatosis, epidermal naevus,

linear porokeratosis

MACROSCOPIC DESCRIPTION:

Specimen labelled: 'Right'. A 5 mm core of skin 3 mm deep, with a

red-brown rough surface. Bisected transversely and all processed. 2-1A.

HY

MICROSCOPIC EXAMINATION:

Sections through multiple levels show skin including dermis. There is

compact keratin with very focal parakeratin overlying epidermis with

basal vacuole Interface reaction and a superficial dermal lymphocytic

infiltrate. There is no spongiosis. There is a superficial

lymphocytic infiltrate with extravasation of erythrocytes.    There are

no fungal elements seen on PAS stained sections. There is no evidence

of dysplasia or malignancy. Seen with Dr P McQuillan

CONCLUSION:

RIGHT HIP/LOWER ABDOMEN RASH, BIOPSY: FEATURES FAVOURING LICHEN

STRIATUS (SEE COMMENT)

Comment: Overall, based on the clinical the features favour lichen

status. In these into the, erythrocyte extravasation is unusual

however the lesion may have been scratched. The main differential

diagnosis based on histology is pityriasis lichenoides et varioliformis

acuta (PLEVA), however this is unusual is limited to one body part.

Drug reaction unlikely in this age group. Viral exanthem can also be

considered however distribution makes it unlikely. There are no

histological features to suggest Incontinentia pigmenti, digitate

dermatosis, epidermal naevus or linear porokeratosis. Furthermore,

Incontinentia pigmenti is a lethal in males unless there is genetic

mosaicism.