JAMA Clinical Challenge

Facial and Upper Body Papules in a Patient With a Family History of Recurrent Pneumothorax

Image of close-up of papules on the patient’s upper back

Sarah J. Felton, MA, MRCP
Vishal Madan, MD, MRCP
A 31-year-old woman presents with a 10-year history of progressive development of small, whitish/skin-colored papules across her forehead, neck, and upper back (Figure). She also has scattered skin tags in this distribution. The patient also reports that her brother and father have similar papular facial rashes, and her father has had recurrent pneumothoraces in the past, necessitating pleurectomy. A skin biopsy obtained from a representative lesion confirms the presence of fibrofolliculomas.

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Author Affiliations: Drs Felton (sarah.felton@srft.nhs.uk) and Madan are affiliated with the Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom.