SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD
A 2-year-old white boy presented with a 3-month history of multiple asymptomatic, rapidly growing cutaneous lesions involving his face, back, and limbs. He was born after an uncomplicated pregnancy and delivery, and his growth and development were appropriate for his age. No associated symptoms such as fever, anorexia, weight loss, or arthralgia were noted.
Physical examination revealed multiple skin-colored to erythematous papules, 1 to 3 mm in diameter, symmetrically distributed on the feet, forehead, chin, and dorsum of both hands. Several subcutaneous nodules, 6 to 7 cm in diameter, mainly located in the periarticular regions of both elbows and knees and in the upper back, were observed (Figure 1). No mucosal lesions were present, and the rest of the physical examination findings were unremarkable. A complete hematological and biochemical survey disclosed no abnormalities. Several skin biopsy specimens were obtained. Representative histopathological features are shown in Figure 2 and Figure 3.
Rozas-Muñoz E, Suñol M, Parareda A, González-Enseñat MA, Pujol RM, Vicente MA. Autoinvolutive Papules and Nodules in a Child—Quiz Case. Arch Dermatol. 2012;148(6):755-760. doi:10.1001/archderm.148.6.755-d