REPORT OF CASES
An 18-year-old black woman presented with asymptomatic disseminated hypopigmented and hyperpigmented papules on her trunk and extremities. She had a history of asymptomatic keratoses since childhood as well as a history of cystic acne and hidradenitis suppurativa. Her family history was significant for a brother and mother with similar hypopigmented and hyperpigmented lesions in the same distribution. On physical examination, she had numerous 1- to 3-mm hypopigmented, hyperkeratotic, flat-topped, nonfollicular papules involving the extremities and trunk with extension to the neck and ears. The hypopigmented papules appeared to be unrelated to any previous lesions. She also had hyperpigmented papules on the distal extremities and the dorsa of her hands and feet (Fig 1). Skin markings were preserved in these lesions. Hyperpigmented macules with central pitting were also observed on her palms and soles. No oral lesions were present. A biopsy specimen was taken from one of the
Singal R, Honig BK, Morison WL, Farmer ER. Hypopigmented, Hyperkeratotic Papules in Two Siblings. Arch Dermatol. 1992;128(3):399–400. doi:10.1001/archderm.1992.01680130113017
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