11th August 2020

A 27-year-old woman is seen in the general dermatology clinic

A 27-year-old woman is seen in the general dermatology clinic. The consultant asks you to describe the skin changes on her legs. You note a bilateral, similar lace-like rash on both of her legs affecting the mid-calves and shins. You ask the patient about the rash and she mentions it has been there for a few years and hasn’t changed much in appearance. You cannot ascertain any other significant medical history. You ask the patient if she is on any medication and she mentions she takes folic acid as she is trying to conceive. She also mentions recently having her second miscarriage, which was in the first trimester of pregnancy (similar to her first). She also mentions her mother and sister also suffer from a similar condition and that her mother died from ‘clots in her lung’.

For the patient above, please select the SINGLE most likely diagnosis of the dermatological manifestation of their systemic condition/disease. Select ONE option from the list above.