A Woman With Nodules and Depressed Scars

A 59-year-old woman exhibited cicatricial alopecia on her scalp, a painless deep nodule on her right arm, and plaques on her breasts, all of which developed over the past 20 years. The nodule and plaques were characterized by erythematous, depressed, and atrophic skin. A biopsy of the arm lesion revealed a lymphocytic perivascular infiltrate and replacement of fat lobules by hyalinized collagen. Direct immunofluorescence indicated granular deposits of IgM and C3 in the dermal vessels and around hair follicles.