JAMES M.GRICHNIKMD, PhDASHFAQ A.MARGHOOBMDALONSCOPEMD
White fibrous papulosis of the neck (WFPN), which was first described by Shimizu et al1 in 1985, clinically presents as asymptomatic white papules, measuring 2 to 3 mm in diameter, on the neck of elderly persons. The lesions are round to oval, clearly marginated, and unrelated to hair follicles. The lesions shown in Figures 1, 2, 3, and 4 were located on the neck of a 58-year-old Japanese man (Figures 1 and 2) and a 68-year old Japanese man (Figures 3 and 4). Dermoscopy of both lesions revealed clearly circumscribed, homogeneous, white areas, including dotted or short, thin vessels, without follicular involvement. Peripheral pigmentation can be seen but fails to form a pigment network (Figures 1 and 2). The diagnosis of WFPN was confirmed histopathologically in both cases (Figure 5 and Figure 6 [hematoxylin-eosin, original magnification ×100]). The histopathologic characteristics of WFPN include relatively well-circumscribed areas consisting of thickened collagen bundles in the papillary to middle dermis, without vascular proliferation, and a decrease of melanin content in the epidermis. These histopathologic features are consistent with the white, nodular, dermoscopic appearance.
Minagawa A, Koga H, Saida T. Dermoscopy of White Fibrous Papulosis of the Neck. Arch Dermatol. 2010;146(2):220. doi:10.1001/archdermatol.2009.368