A man in his 60s presented with a 7-year history of a progressive pruritic eruption involving the nose and dorsal hands. He had no improvement following treatment with class 1 topical corticosteroids and keratolytic emollients. On review of systems, he endorsed photosensitivity during childhood only. He denied any history of blistering, angioedema, dysphagia, hoarseness, dyspnea, or weight loss. Physical examination revealed multiple skin-colored, waxy, smooth and variably verrucous papules and plaques on the dorsum of the nose and hands. (Figure, A and B).
Sluzevich JC, Hoesly PM. Pruritic Waxy and Verrucous Papules in a Middle-Aged Man. JAMA Dermatol. Published online October 26, 2016. doi:10.1001/jamadermatol.2016.3602