Progressive reticular atrophy on the face

A 9 year old boy presented with a six year history of slowly progressive reticular atrophy, tiny papules, and open comedones on the right cheek (fig 1). He did not report any itching or pain and had received no treatment. A year previously, an atrophic patch with alopecia appeared on the right temporal area (fig 2). The parents reported no personal history or family history. A biopsy sample taken from the temporal lesions showed thinning of the epidermis and dermis, absence of hair follicles, and mild perivascular lymphocytic infiltration of the superficial dermis.