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February 2011February 21, 2011

Asymptomatic Red and Brown Lesions on the Face and Neck of a 15-Year-Old Boy—Diagnosis

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Arch Dermatol. 2011;147(2):235-240. doi:10.1001/archdermatol.2010.424-b

Histopathologic examination of the skin biopsy specimen revealed mild epidermal hyperplasia and increased melanin in basal keratinocytes. A mild, superficial, perivascular, lymphocytic infiltration surrounded the dilated papillary vasculature. Slightly dilated hair follicles containing lamellar keratin plugs, tortuous hair, and perifollicular fibrosis were noted. The histologic findings supported the clinical diagnosis of erythromelanosis follicularis faciei et colli. The patient was treated with tretinoin cream, 0.05%. The pigmented and erythematous lesions had slightly faded after a 3-month course of treatment, but the follicular papules persisted.

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