Some atrophic lesions are more visible than palpable and are thus classified as macules. Among atrophic dermatoses, some are exclusively atrophic (e.g., superficial and/or mid-dermal elastolysis), while in others, atrophy is only part of the various existing primary lesions. This is particularly the case in poikiloderma (addressed in Chap.​ 27), where atrophy is associated with telangiectases and reticulate pigmentary changes.

Cutaneous atrophy is one of the signs of skin aging (cf. Figs. 12.​61, 12.​62, and 12.​63). Cutaneous atrophy can be important in patients with rheumatoid arthritis, endogenous or iatrogenic hypercorticism, or who are being treated with hydroxyurea. Cutaneous atrophy is associated with other dermatological lesions in connective tissue diseases, such as lupus erythematosus and dermatomyositis, infectious diseases (e.g., Lyme borreliosis and syphilis), certain immune deficiencies (e.g., TAP deficiency: transporter associated with antigen processing), and cutaneous T-cell lymphoma.

Causes of lipoatrophy are presented in Table 26.1.