A 10-year-old boy presented with a lifelong history of generalized pruritus. His mother reported that when he was 2 years old he began developing blisters that healed, leaving small scars. He required speech therapy for persistent hoarseness, which had been present since he began talking. He was evaluated in the otolaryngology department for the dysphonia and for thickening of the lower lip. Examination in the dermatology clinic revealed superficial pocklike scars on the patient's face and extremities. Flesh-colored beaded papules were seen lining the upper and lower eyelids of both eyes (Figure 1). There were papules on the sublingual frenulum (Figure 2) and mild thickening of the lower lip. An older brother had similar clinical findings. A biopsy specimen of the lower lip was obtained for histologic analysis (Figure 3).
Cole JA, Novosel TA, Williams JV, et al. Pocklike Scarring and Sublingual Papules in a Child—Quiz Case. Arch Dermatol. 2008;144(10):1383–1388. doi:10.1001/archderm.144.10.1383-a
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