A 20-year-old Peruvian man presented for evaluation of an occasionally painful papule located on the superior margin of the right manubrioclavicular joint that had been present since birth (Figure 1). He wanted to have the papule removed both for cosmetic reasons and for prevention of injury while he was in active duty in the Air Force. He was otherwise healthy.
Physical examination revealed a single 2-cm, smooth-surfaced, flesh-colored, firm, tender papule located approximately 5 cm superior to the right manubrioclavicular joint line along the sternocleidomastoid muscle (Figure 1).