SELF ASSESSMENT QUIZ SAQ Multiple hyperpigmented, warty and greasy papules AK Douieb MD1, Bayoumi Eassa MD2 1Consultant, Department of Dermatology, HPLM, Larache, Morocco 2Department of Dermatology, Farwaniya Hospital, Kuwait A 54-year-old man presented with multiple positive family history was present with similar yellow–brown, raised, keratotic, mildly greasy lesions in his son. pruritic papules of 20 years duration. The lesions started on the chest and gradually progressed to Skin biopsy was obtained from the keratotic involve the scalp, forehead, nasolabial folds, papules and showed suprabasal cleft with few and groin area. Examination revealed multiple acantholytic keratinocytes. The upper part of hyperpigmented, warty, greasy papules, some of the epidermis showed 2 types of dyskeratotic them showing follicular appearance (Fig. 1). All cells; corps ronds which were located in stratum routine hematological investigations were normal. granulosum and grains which were located in General physical examination was normal. A stratum corneum (Fig. 2). Fig. 1 a,b,c,d Clinical pictures showing multiple hyperpigmented, warty and greasy papules over trunk and face Correspondence: Dr. AK Douieb MD, Consultant, Department of Dermatology, HPLM, Larache, Morocco, Tel: 0021261204376 Email:
[email protected] The Gulf Journal of Dermatology and Venereology Volume 17, No.1, April 2010 65 Douieb AK et. al. SAQ Fig. 2 a,b,c,d H & E section What is your diagnosis? mother and her daughter were affected. .2-3 The 1. Prurigo Nodularis disease commonly manifests from age 6-20 years; 2. Lichen planus however, patients have presented as early as age 3. Confluent and reticulated papillomatosis 4 years and as late as age 70 years.