Atrophoderma of Pasini and Pierini (ATPP) is a rare skin condition that results in patchy areas of discolored skin. The main symptom of atrophoderma of Pasini and Pierini is multiple irregularly shaped, dark or light areas of skin in which the tissue under the skin breaks down resulting in a depression (dent). Symptoms usually start in adolescence or early adulthood and can progress for 10-20 years. The cause of ATPP is unknown. Diagnosis is based on clinical examination and a skin biopsy. There is no single specific treatment for this rare condition.

The main symptom of atrophoderma of Pasini and Pierini is dark or light-colored indented areas of skin with irregular shapes and borders. Some people have pain, itching, or numbness associated with the skin findings.

The skin findings in this condition usually appear in adolescence or early adulthood. The trunk is usually affected first and then the changes in the skin may spread to the chest, arms and stomach. Atrophoderma of Pasini and Pierini may progress over 10-20 years and then stops. Very rarely, this condition will progress to systemic sclerosis.

Borrelia burgdorferi may be the cause. In others, a possible genetic cause is suspected.

Atrophoderma of Pasini and Pierini is diagnosed based on a clinical examination and a skin biopsy to look at a piece of affected skin under the microscope.

Specialists who may be involved in the care of someone with atrophoderma of Pasini and Pierini include:

• Dermatologist
• Pharmacist

The exact number of people with atrophoderma of Pasini and Pierini is unknown. It is extremely rare, and less than 100 cases have been reported in the literature.