A 46 Year Old African American Woman with White Spots

Abstract

A 46 year old African American female presents for evaluation of white spots on both her arms that have been spreading. She says that she first noted the spots 2 years ago. There were initially two spots on her right arm and three on her left arm. They have combined and become larger. Before this, she says she had perfect skin and did not even have acne as a teenager. She denies any pain or trauma to the areas. She says she has tried to scrub the spots when showering but it has not helped. She has also applied several name brand lotions to the spots daily. While her skin has remained moisturized, her lesions have not improved. She is very self-conscious about the lesions and is afraid that it may be “some type of cancer.” She tries to wear long sleeve shirts to avoid having her arms seen because she feels it makes her look deformed. She is upset because the weather is getting warm but she is embarrassed to wear short sleeve t-shirts. She does feel she gained weight over the last several months and becomes fatigued very quickly. She denies any fever, chills, headache, shortness of breath, palpitations, or excessive sweating. She feels her menses have been less frequent. She has no allergies and does not take any medications.