A 47-year-old man presented with a 20-year history of asymptomatic hypopigmented papules that had initially involved the lateral aspect of the cheeks but had slowly spread to the neck and shoulders. Multiple blistering sunburns had preceded the initial lesions. The patient was otherwise healthy and took no medications.
Physical examination revealed multiple (>60) symmetrically distributed, scaling, pink and hypopigmented papules with ill-defined borders involving the lateral aspect of both cheeks and the jawline, neck, and shoulders (Figure 1 and
Figure 2). Individual papules were irregular and stellate and formed a reticulated network. Several 4-mm punch biopsy specimens were obtained from different sites. Microscopic features of the lesion are shown in Figure 3 and Figure 4.
Vin-Christian K, Grekin R, McCalmont T. Hypopigmented Papules of the Cheeks, Neck, and Shoulders. Arch Dermatol. 1999;135(4):463-a-468. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-4-dof0499