A 51-year-old white woman presented with a 17-year history of multiple, asymptomatic papules on her face, neck, and upper chest area. The papules had previously been diagnosed clinically as milia and later as angiofibromas for which she underwent a complete evaluation for tuberous sclerosis. A biopsy had not previously been performed on these lesions. The patient was otherwise healthy except that she had had a spontaneous pneumothorax the preceding year. Her sister, father, and paternal grandmother had also developed similar lesions during their 30s.
Kim EJ, Stadecker M, Washburn JC. Multiple Facial Papules in an Adult—Quiz Case. Arch Dermatol. 2003;139(2):215-220. doi:10.1001/archderm.139.2.215-e