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September 1996

Lightly Pigmented Facial Papules of Variable Size

Author Affiliations

St Agnes Hospital, Baltimore, Md

Arch Dermatol. 1996;132(9):1110. doi:10.1001/archderm.1996.03890330125024

REPORT OF A CASE  A 21-year-old man was admitted to the medical intensive care unit with the diagnosis of meningitis and seizures. On close inspection, lightly pigmented centrofacial papules of variable size were seen (Figure 1). Hypopigmented patches and numerous small spots were present in a confettilike pattern on the patient's left thigh (Figure 2). The results of the ophthalmologic examination were normal.A computed tomographic scan of the patient's head showed multiple periventricular calcifications, findings consistent with periventricular hamartomata. The computed tomographic scan and a magnetic resonance imaging scan of the head also showed a 2-cm enhancing mass in the septum pellucidum region that was thought to represent a large hamartoma or a subependymal giant cell astrocytoma. Multiple echogenic masses thought to represent angiomyolipomas were seen in both kidneys on ultrasound.A skin biopsy specimen from a facial lesion was obtained for routine histopathologic studies (Figure 3).What

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