A 51-year-old woman presented with a 5-year history of a progressive eruption of asymptomatic papules on the dorsal aspect of her hands and wrists. She had no other history of medical problems.
Physical examination revealed approximately 40 discrete flesh-colored to translucent papules located exclusively and symmetrically on the dorsum of the hands and wrists (Figure 1). They were round and firm, with a smooth surface. The surrounding skin was normal. The findings of the rest of the physical examination were unremarkable. A 4-mm punch biopsy specimen was obtained from a papule (Figure 2).
Callaly EL, Mulligan N, Powell FC. Multiple Painless Papules on the Wrists—Quiz Case. Arch Dermatol. 2007;143(6):791-796. doi:10.1001/archderm.143.6.791-d