Acta Dermato-Venereologica 99-6CompleteContent | Page 31

631 Stable Firm Pink Papules on a Woman in her 60s: A Quiz Catherine BAKER 1 , Katherine R. LEE 2 , Anh Khoa PHAM 2 , Robert E. LEBLANC 1,3 and Joi B. CARTER 1,2 1 Department of Dermatology, Geisel School of Medicine, Dartmouth, 03784 West Lebanon, 2 Section of Dermatology, Department of Surgery, and 3 Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Dartmouth, USA. E-mail: catherine.m.baker. [email protected] A 66-year-old woman presented to dermatology with long- standing asymptomatic firm to rubbery smooth pink papules on her forehead, posterior neck, and upper back (Fig. 1). Biopsy of one of these lesions showed a circumscribed der- mal nodule comprised of bland, intersecting smooth muscle fascicles (Fig. 2). Further history revealed that the patient had undergone hysterectomy at age 34 for uterine fibroids. The patient’s mother, two daughters, and maternal aunt Fig. 1. Pair of 4-mm pink papules on forehead. had also undergone hysterectomy for fibroids. Her mother, daughter, and maternal cousin had similar skin lesions. What is your diagnosis? See next page for answer. Fig. 2. Punch biopsy of a trunk papule revealed a circumscribed superficial dermal nodule comprised of intersecting fascicles of smooth muscle (H&E, original magnification 20x). QUIZ SECTION This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3163 Acta Derm Venereol 2019; 99: 631–632