Chronic Pustular Eruption of the Thumbs

Abstract

A 30-year-old black woman presented for the evaluation of multiple plaques on her face and scalp. The plaques, which were asymptomatic, had been present for approximately 2 months. The patient had no significant medical history.Therewasnofamilyhistoryofsimilar lesions.Physicalexaminationrevealedseveralviolaceousannularplaques with slightly raised scaly borders scattered over the face and scalp (Figure1). The plaques on the scalp were alopecic. The remainder of the physical examination was significant only for scattered brown macules on the bilateral aspectof thepalms.Apunchbiopsyspecimenwasobtained from a scalp plaque (Figure 2 and Figure 3). What is your diagnosis?