Multiple flesh colored papules on face and trunk

Presenter: Sarah Croft DO, Jill Salyards DO, Brandon Shutty DO
Dermatology Program: Nova Southeastern University/Largo Medical Center
Program Director: Richard Miller, DO
Submitted on: Jun 6, 2014

CHIEF COMPLAINT:  A 52 year old Caucasian male presents for initial evaluation with multiple pruritic “bumps” on his back.

CLINICAL HISTORY:

Signs and symptoms:  A 52 year old Caucasian male presents for initial evaluation with multiple pruritic “bumps” on his back that seem to be increasing in number over 2 years time as well as new lesions on the cheeks that he cuts while shaving.

Previous Treatment:  Topical emollients do not relieve symptoms.

Other information:  Dermatologic history: actinic keratoses and non-melanoma skin cancer
Medical history: traumatic brain injury after MVA, seizure disorder, depression, bipolar disorder, asthma
Family history: mother with throat cancer, father with colon cancer
Social history: less than 1 pack per day smoker

PHYSICAL EXAM:

Multiple flesh-colored, well circumscribed, umbilicated papules scattered on the back, abdomen, chest, and face.

LABORATORY TESTS:

DERMATOHISTOPATHOLOGY:

Shave biopsy demonstrated a proliferation of sebaceous epithelium emanating from the epidermis. Mature sebaceous cells outnumber peripherally located germinative cells.

DIFFERENTIAL DIAGNOSIS:

1.   Basal Cell Carcinoma
2.   Molluscum contagiosum
3.   Epidermoid cyst
4.   Sebaceous hyperplasia
5.   Verruca vulgaris


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