A 47-year-old woman presented to our clinic with a 30-year history of numerous facial lesions. She reported that the lesions were relatively stable in size and asymptomatic until recently. Over the past 3 to 4 years, 3 of these lesions became larger, ulcerated, and tender. Her medical history was unremarkable. Her family history was notable for a daughter who was beginning to develop similar lesions on the face. In addition, the patient was recently reacquainted with her biologic mother, who also has numerous, similar facial lesions.