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SKINDIA QUIZ
Year : 2016  |  Volume : 7  |  Issue : 5  |  Page : 451-453  

SkIndia Quiz 28: Sudden onset generalized papules in a pubertal female


Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India

Date of Web Publication14-Sep-2016

Correspondence Address:
Dr. Anupam Das
Building - “Prerana,” 19, Phoolbagan, Kolkata - 700 086, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.185529

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How to cite this article:
Bhattacharya S, Das A, Das D, Podder I, Das NK, Chowdhury SN. SkIndia Quiz 28: Sudden onset generalized papules in a pubertal female. Indian Dermatol Online J 2016;7:451-3

How to cite this URL:
Bhattacharya S, Das A, Das D, Podder I, Das NK, Chowdhury SN. SkIndia Quiz 28: Sudden onset generalized papules in a pubertal female. Indian Dermatol Online J [serial online] 2016 [cited 2019 Dec 5];7:451-3. Available from: http://www.idoj.in/text.asp?2016/7/5/451/185529

A 15-year-old female presented to us with the complaints of sudden appearance of numerous small nonpruritic eruptions all over the body. To start with, the lesions appeared on the eyelids at the age of 7 years. At pubertal age, this was followed by successive eruptions on the upper extremities, axillae, neck and upper abdomen, respectively [Figure 1]a, [Figure 2] and [Figure 3]. The lesions rapidly increased in number over the past two months. The patient did not report any other medical problems or use of over-the-counter medications. There was no spontaneous resolution of any of the lesions during the period of observation. Her mother had similar lesions, over the eyelids and face [Figure 1]b for as long as she could remember, but these were confined to these areas and had not progressed. The girl's maternal uncle also had a history of similar lesions in his adolescence, but these had resolved spontaneously without any intervention. Cutaneous examination revealed numerous small skin-colored to brown flat-topped papules about 1-2 mm in diameter scattered over the face, trunk, back, abdomen and extremities. These were symmetrical in distribution involving both follicular and nonfollicular areas. No puncta or significant surface changes were noted and Darier's sign was negative. Physical examination of the rest of the body did not reveal any other significant abnormality. A punch biopsy was done from the right forearm, which showed a normal epidermis along with dermis, which had numerous tubular structures, embedded in dense collagen stroma. The ducts were lined by two rows of epithelial cells, some of which had comma-like tails. Ductal lumina were filled with an amorphous material [Figure 4] and [Figure 5].
Figure 1: Skin-colored to brown flat-topped papules over the face of the patient (a) and her mother (b)

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Figure 2: Bilaterally symmetrical distribution of flat-topped papules over the extremities

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Figure 3: Brown-colored papules over the front and bank of abdomen

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Figure 4: Photomicrograph showing a normal epidermis. Dermis has numerous tubular structures, embedded in dense collagen stroma (H and E, ×10)

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Figure 5: Photomicrograph showing ducts lined by two rows of epithelial cells, some of them having comma-like tails. Ductal lumina were filled with an amorphous material (H and E, ×40)

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   References Top

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2.
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4.
Verma SB. An unusual case of eruptive syringomas presenting as itchy symmetrical lesions on both forearms in a patient of hyperkeratotic eczema. Indian Dermatol Online J 2011;2:104-6.  Back to cited text no. 4
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Johnson BL, Yan AC Jr. Tumors of epidermal appendages: In: Elder DE, Elenitsas R, Johnson BL, Murphy GF, Xu X. eds. Lever's Histopathology of the Skin. 10th ed. Philadelphia: Lippincott Williams and Wilkins Publishers; 2009. p. 884-5.  Back to cited text no. 5
    
6.
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7.
Frazier CC, Camacho AP, Cockerell CJ. The treatment of eruptive syringomas in an African American patient with a combination of trichloroacetic acid and CO2 laser destruction. Dermatol Surg 2001;27:489-92.  Back to cited text no. 7
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  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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