An 8-year-old boy presents with a 6 months history of an ill defined, hypopigmented slightly atrophic macule on the face. The most likely diagnosis is:
High-Yield Explanation
It is the first sign of leprosy, only few hypopigmented, or hyperpigmented erythematous skin macules, often with some slight sensory loss, but the nerve are not tender or thickened. Histopathologically there is scanty lymphocytic-histocytic infiltration around skin appendages, nerves, and blood vessels. The lesion may clear spontaneously in a year or two, but specific treatment is recommended. Ref: Anthony Du Vivier, Phillip H. McKee, Chapter 17, "Tropical Infections of The Skin", In the book, "Atlas of Clinical Dermatology", Elsivier Publication, 2002, 3rd Edition, Spain, Page 343