Atrophoderma of Pasini and Pierini and Systemic Scleroderma

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Abstract
To the Editor.— Atrophoderma of Pasini and Pierini refers to asymptomatic, depressed, slightly hyperpigmented lesions usually located on the back and most often occurring in young people.1 This condition is usually described as an isolated finding or in conjunction with morphea or lichen sclerosis et atrophicus in other sites. A review of the literature failed to disclose the progression of atrophoderma of Pasini and Pierini to systemic scleroderma. We report herein such a case. Report of a Case.— A 42-year-old woman had sharply demarcated, slightly hyperpigmented, thinned, depressed plaques on her back in May 1979. In March 1980, the patient noted stiffness in her hands, which, at first, had appeared swollen and puffy. These changes progressed to tautness and stiffness, with concurrent Raynaud's phenomenon. Mild shortness of breath and dysphagia had also developed during the past six months. The physical examination showed sclerodactyly with periungual telangiectasia. The skin on

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