A 24-year-old healthy African American woman presented with a 10-year history of “growths” on her right buttock that had started as a single lump over the sacrum. Over time, new lesions developed and increased in size, but after 5 years, the masses stopped growing and changing. There was no family history of similar lesions.
Physical examination revealed multiple soft, sessile, skin-colored to hyperpigmented grouped papules and nodules coalescing into plaques over a 16 × 10-cm area of the sacrum and right buttock (Figure 1). The plaques had a wrinkled, cerebriform surface. Two nodules were excised for histologic evaluation (Figure 2 and Figure 3).