Atrophoderma of Pasini and Pierini (APP) is
an idiopathic disorder of dermal atrophy, presenting
as round or oval depressed lesions most commonly
observed on the trunk and extremities. Herein, we
report the first case of APP initially appearing on the
head. Histopathologic examination of lesional skin
demonstrated a decrease in elastic fibers. Serologic
tests for Borrelia and antinuclear antibody titers
were negative. There was no noted improvement
after 6 weeks tretament with Hydroxycholoroquine
200 mg/tab BID. Definitive disease etiology and
treatment of APP remains to be elucidated.