ABSTRACT
Idiopathic atrophoderma Pasini Pierini (IAPP) is a typically benign, asymptomatic, skin-limited atrophic condition. The incidence of IAPP in Europe is greater than in North America. IAPP manifests itself as single or multiple, well-demarcated, hyper pigmented, asymptomatic patches. The disorder begins with the appearance of a slightly erythematous lesion. An elliptical biopsy should be obtained from the edge of the lesion and deep enough to include the subcutaneous tissue, making it easier to detect the transition between normal and lesional dermis. The histological features are usually nondiagnostic. Screening tests such as the Western blot may be performed to determine the presence of anti-B. burgdorferi antibodies. Skin disorders resembling IAPP are late-stage morphea, lichen sclerosus et atrophicus, postinflammatory hyper pigmentation, atrophoderma of Moulin, systematized epidermal nevus, and anetoderma. Topical and systemic steroids are the most common medical approach. Psoralen-ultraviolet A (PUVA), potassium benzoic acid, D-penicillamine, and retinoids have all been used with variable efficacy.
