Routine hematoxylin-eosin–stained slides showed a dome-shaped, umbilicated lesion with a central erosion. Collections of histiocytes and sparse perivascular infiltrates of lymphocytes were present within the dermis directly underlying the erosion. In the deeper aspects of the dermis, there was a rare focus where the histiocytes formed a palisading granuloma.
A therapeutic trial of hydroxychloroquine (6 mg/kg per day) was instituted because of the generalized distribution of the lesions. After 3 months of therapy, all but the lesions on the dorsal aspect of the hand had regressed, leaving only hypopigmentation. The medication was well tolerated, with no adverse effects.
Asymptomatic Papules on a Child. Arch Dermatol. 2001;137(12):1647-1652. doi: