On scanning magnification, the biopsy specimen appeared normal. Higher magnification showed clusters of smaller collagen bundles that were irregularly arranged. The elastin stain showed increased elastic fibers in the areas of altered collagen; the elastic fibers were coarse, irregular, and interconnected. These findings are characteristic of a connective tissue nevus of the elastic type. A punch biopsy specimen from a small papule on the wrist showed similar findings.
Radiographs of the pelvis and long bones of the extremities showed small, discrete, opaque densities (circled in red on Figure 4) consistent with osteopoikilosis.
Widespread Pea-Sized Papules and Gooseflesh Plaques in a 44-Year-Old Woman. Arch Dermatol. 2000;136(8):1055-1060. doi: