Itchy nodules may be a drug reaction

Some lesions show loss of pigment centrally with increased pigment around the outer edge.

The inflammatory condition hypertrophic lichen planus caused central destruction of skin melanocytes, giving the pale areas. Stimulation of those melanocytes around the edge of the inflammation caused hyperpigmentation.

This pattern, if seen on the face, would most likely be due to discoid lupus erythematosus. These lesions were also itchy, a feature of lichen planus. Most cases also have itchy purple polygonal papules at the wrists and some have a lacy, white net-like pattern on the buccal mucosa.

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