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September 15, 2008

Multiple Asymptomatic Papules on the Face—Quiz Case

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Arch Dermatol. 2008;144(9):1217-1222. doi:10.1001/archderm.144.9.1217-b

A 47-year-old man presented with a 5-year history of nonpruritic papules on the face, which were progressively and slowly increasing in number and size. Physical examination revealed multiple, confluent, soft, skin-colored papules on the patient's chin (Figure 1), with 2 larger lesions on the lateral nose. Similar lesions were not observed anywhere else. The patient's physical appearance was otherwise normal, and we did not notice any pigmented lesion such as lentigines or blue nevi during the physical examination. He had no notable medical history and did not have any other symptoms such as headaches, visual abnormalities, fatigue, or other findings that pointed to endocrine overactivity after a review of systems. No family members had similar cutaneous lesions, a history of endocrine or cardiac disease, or sudden death. A shave biopsy specimen from 1 lesion of the nose was obtained, and histologic examination was performed with hematoxylin-eosin staining (Figure 2 and Figure 3).

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