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JAMA Dermatology Clinicopathological Challenge
September 2015

Asymptomatic Papular Eruption in a Teenage Boy

Author Affiliations
  • 1Division of Dermatology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
  • 2Department of Pathology, Loyola University Medical Center, Maywood, Illinois
JAMA Dermatol. 2015;151(9):1019-1020. doi:10.1001/jamadermatol.2015.1432

A healthy teenaged boy was seen with a papular eruption on the trunk and legs of 3 months’ duration. He had initially developed lesions on his legs, which then spread to his neck, chest, and buttocks. This eruption was asymptomatic, and the patient reported no history of vesiculation. His mother noted minimal evolution of the lesions, except for recent flattening of those on the legs. Physical examination showed numerous discrete (1 to 3 mm) smooth brown papules concentrated on the neck, chest, anterior and lateral thighs, and buttocks (Figure 1). Several lesions had a positive Darier sign (Figure 1A).

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