By Gary M. White, MD
Atrophoderma of Pasini and Pierini is thought to be a variant of morphea that typically occurs on the back as brown, slightly atrophic areas.
Tan to light-brown atrophic patches several to tens of centimeters in size on the back occurs in this disease. They are usually symmetric and asymptomatic. Lesions may also develop elsewhere and may at times resemble morphea. The darker color of the lesions compared with the skin adds to their appearance of being depressed. However, the lesions are atrophic and some lesions' dermal atrophy is so pronounced that a distinct "drop off" at the edge is palpable. Serum antibodies to Borrelia burgdorferi have been reported positive in a proportion of patients. A zosteriform distribution and overlap cases with morphea and LSA may occur.
No treatment is highly effective. Any therapies for morphea may be tried, e.g., a potent topical steroid BID for two months.
IgM was positive for Borrelia burgdorferi and six weeks of doxycycline 200 mg/day improved the lesions. Ann Dermatol. 2011 Aug; 23(3): 352–356
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