White ankle scars
We discovered that these white lesions were remnants of a deeper issue that linked back to significant events in the patient’s medical past.
Atrophic scarring occurs only after trauma.
Guttate morphea lesions are sclerotic and may be depressed.
Extra-genital lichen sclerosus is characterized by polygonal, shiny, ivory-white sclerotic lesions with or without follicular plugging.
Tuberculoid leprosy involves loss of nociception, hypotrichosis, and palpable thickened regional nerves (eg, great auricular, sural, or ulnar nerve).
Treatment requires long-term anticoagulation
Our patient had APS and the mainstay of treatment is long-term systemic anticoagulation along with attentive wound care.6 Warfarin is preferred over a direct oral anticoagulant as it is more effective in the prevention of recurrent thrombosis in patients with APS.7
Our patient was started on warfarin. Since APS may occur as a primary condition or in the setting of a systemic disease, such as systemic lupus erythematosus, she was referred to a rheumatologist.
