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August 16, 2010

Multiple Papules and Nodules of the Scalp—Quiz Case

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Dermatol. 2010;146(8):911-916. doi:10.1001/archdermatol.2010.173-a

A 72-year-old white woman presented with a 2-year history of multiple scalp lesions. Except for mild pruritus, these lesions were asymptomatic. The patient was otherwise healthy without any other medical problems. She denied trauma to the area. These lesions had not been previously treated.

Physical examination revealed multiple pink, partially crusted and eroded smooth-topped, compressible papules and nodules on the left temporal and parietal scalp. Some papules were clustered together in a grapelike array. The largest lesion measured 0.8 × 1.2 cm. No active drainage or increased warmth was appreciated (Figure 1). There was no regional lymphadenopathy. A shave biopsy was taken from a representative lesion for histologic analysis (Figure 2and Figure 3).

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