This 8- year-old girl, born of nonrelative parents, presented with a one year history of darkening and thickening of body folds especially neck and axilla. It began with pruritic, hyperpigmented and corrugated plaques on her neck, axilla, groin and perioral and periumbilical area. Family history is negative for any skin disease.

Drug history: levothyroxine Her disease is gradually progressive.