What is the differential diagnosis (DD) of linear poikiloderma on the inner arm, present for 3 years?

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Differential Diagnosis for Linear Poikiloderma of Inner Arm

  • Single most likely diagnosis
    • Dowling-Degos disease: A rare genetic disorder characterized by reticular pigmentation of the skin, often presenting with linear or reticulated poikiloderma, particularly in the flexural areas. The condition typically starts in adulthood and progresses slowly.
  • Other Likely diagnoses
    • Poikiloderma of Civatte: A common condition characterized by reticulated pigmentation, telangiectasias, and atrophy, typically affecting the neck and, less commonly, other sun-exposed areas. However, it can occasionally present in non-sun-exposed areas.
    • Linear scleroderma (morphea): A form of localized scleroderma that can present with linear or band-like lesions, which may include poikilodermatous changes. It often affects the limbs.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Chronic radiation dermatitis: This condition can result from prolonged exposure to low doses of radiation and may present with poikilodermatous changes, among other symptoms. It's crucial to consider this diagnosis due to its potential association with underlying malignancy or significant radiation exposure.
    • Mycosis fungoides (cutaneous T-cell lymphoma): Although less common, mycosis fungoides can present with a variety of skin manifestations, including poikiloderma. Early diagnosis is critical due to its potential progression and impact on prognosis.
  • Rare diagnoses
    • Klippel-Trenaunay syndrome: A rare congenital malformation that can include poikilodermatous changes, among other features like port-wine stains, varicose veins, and bony or soft tissue hypertrophy.
    • Goltz-Gorlin syndrome (focal dermal hypoplasia): A rare genetic disorder characterized by congenital anomalies, including skin lesions that may resemble poikiloderma, fat herniations, and other systemic features.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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