Cutaneous Signs of Vascular Disorders: Atrophie Blanche

By Charles E. Crutchfield III, MD, Eric J. Lewis, MD, PhD, and Humberto Gallego, MD

A 57-year-old man with a history of venous stasis leg ulceration wondered about the “white spots” on his leg. The condition is atrophie blanche, which manifests as smooth, ivory-white macules and plaques of sclerosis stippled with telangiectasia that often are surrounded by mild to moderate pigmentation.

Atrophie blanche is seen most commonly in association with the healing phase of livedo vasculopathy and hypertensive vasculopathy, but it is noted also as a nonspecific finding in diabetes mellitus, dysproteinemic states, lupus erythematosus, and venous stasis. Treatment for atrophie blanche is directed at prevention by addressing the underlying medical condition.