A 43-year-old woman with a history of obesity and type 2 diabetes mellitus presented with cutaneous lesions in the vulva and groin, which had been present for > 1 year. The lesions began as small, tender, erythematous follicular papules that healed with flaccid, wrinkled protuberant plaques ( Fig. 1 ). Symptoms included pain with friction and recurrent mons pubis swelling. The patient endorsed shaving the area and using depilatories, both which resulted in bleeding and irritation. Laboratory test results, including a test for antinuclear antibodies, were unremarkable.
Anetoderma is characterized by a focal loss of dermal elastic tissue, resulting in atrophic depressions or outpouchings of flaccid skin. It can be primary (occurring in areas of previously normal skin), secondary (occurring in areas of prior skin pathology), congenital, familial, or drug-induced. Skin eruptions preceding secondary anetoderma include acne vulgaris, varicella, lichen planus, folliculitis, granuloma annulare, and papular eruption of HIV, among others. ( Kineston et al., 2008 ). Anetoderma has been associated with autoimmune disorders, such as Grave’s disease, autoimmune hemolysis, systemic sclerosis, lupus erythematosus, and antiphospholipid syndrome ( Xia et al., 2017 ).