An 8-year-old African American girl presented with a 3-month history of mildly pruritic papules that had appeared first on her neck and then on her vulva. The lesions had gradually increased in size and number. The patient was otherwise healthy, and there was no known family history of similar lesions.
The child was Tanner stage 1 for breast and pubic hair development. Cutaneous examination showed multiple 2- to 4-mm skin-colored and hyperpigmented papules on her neck (Figure 1) and vulva (Figure 2). Genital lesions were present on the mons pubis and symmetrically on the labia majora; scattered suprapubic lesions were also present. The papules were somewhat flat-topped, with an angular outline. A biopsy specimen was obtained from a vulvar papule (Figure 3).
Trager JDK, Silvers J, Reed JA, Scott RA. Neck and Vulvar Papules in an 8-Year-Old Girl. Arch Dermatol. 1999;135(2):203-208. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-2-dof0299