Annular atrophy of the ankles. A case of partial lipodystrophy.

A band of subcutaneous tissue layer around both ankles of a 6-year-old girl disappeared rapidly. The atrophy was preceded by a short period of symptomless noninflammatory subcutaneous swelling of the area. The residual overlying skin was entirely normal in appearance, color, and texture except for venous patterning and an increase in local hair growth. Radiologic survey revealed increased growth lines in the underlying tibiae. Previous examples of this unique clinical expression have been labeled as "lipo-atrophia annularis." A strong family history of diabetes as well as consanguinity supported our view that this child's skin change represented a form of partial atrophic lipodystrophy. The pathogenesis remains obscure, although hereditable local abnormalities in cellular glucose and lipid metabolism were possibly responsible.