A 42-year-old white housewife first developed lesions on her scalp at the age of 12. These lesions have been continuously appearing in large numbers ever since. Several of them were repeatedly removed by surgery, only to be replaced by new ones. Recently, a similar lesion developed on the upper back and another one on the right buttock; othewise, the location has been limited to the scalp.
In her past history there are streptococcic throat infection at age 14 and high blood pressure since the age of 25. Out of 3 pregnancies, 2 ended in still-births; the only living child died of leukemia.
In the family history, there is record of similar lesions in the preceding 3 generations on the maternal side, namely, in the patient's great-grandmother, grandfather, mother, and one uncle. Two of her 3 siblings, 1 sister and 1 brother, are also affected. The onset of the lesions in the mother,