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JAMA Dermatology Clinicopathological Challenge
February 3, 2021

Follicular Papules in a Linear Distribution on a Child’s Face

Author Affiliations
  • 1Department of Dermatology, Hospital San Pablo, Coquimbo, Chile
  • 2Department of Pathology, Hospital San Pablo, Coquimbo, Chile
JAMA Dermatol. 2021;157(3):340-341. doi:10.1001/jamadermatol.2020.5588

A girl younger than 2 years presented with a 1-year history of slightly pruritic lesions involving her face. She was born after an uncomplicated pregnancy and delivery, and her growth and development were appropriate for her age. No associated symptoms such as fever, anorexia, or weight loss were noted. Physical examination revealed multiple skin-colored and erythematous follicular papules, 1 to 2 mm in diameter, distributed in a segmental pattern on the right side of the forehead, as well as the dorsum and tip of the nose. A small, excoriated plaque was also noted on the right malar area (Figure 1A). No mucosal lesions were present, and the rest of the physical examination findings were unremarkable. A complete hematological and biochemical survey, including blood cell count, liver and renal function tests, C-reactive protein levels, thyroid function, rheumatoid factor, and antinuclear antibodies, disclosed no abnormalities. Two skin punch biopsies were taken from the forehead and nose. Representative histopathological features are shown in Figure 1B and C.

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