Woman Gets Heated ... Literally


Recently, a 57-year-old woman was informed by her husband that she has a discolored area of skin on her back. This discovery followed a prolonged period of back pain, for which she was prescribed an NSAID. When this yielded no relief, she started sleeping with an electric heating pad, held in place by an elastic bandage, to ease the pain.

She reports mild itching in the affected area. She claims to be in good health otherwise and is not taking any medication.

The patient is in no acute distress but has obvious difficulty walking without pain. Covering her back, from the bra strap down, is modest erythema, a reticular pattern of modest hyperpigmentation, and focal areas of mild scaling.

No tenderness or increased warmth is detected on palpation. No notable changes are seen elsewhere on her skin.

What is the diagnosis?

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