April 2001

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The patient is a 7-year old African American male who presented to the Washington University Pediatric Dermatology clinic with a three-month history of non-tender, nonpruritic nodules on his bilateral forearms. There was no previous biopsy or treatment intervention.

Physical examination: Examination revealed a developmentally delayed, short statured child with low set ears and hypertelorism. At his initial visit, the patient had multiple, fine, skin-colored papules of the face and loss of lateral eyebrows with folliculocentric papules. Four intradermal nodules measuring 1.5-2.0 cm in diameter were located on his arms (Figure 1). Two weeks later, he presented with multiple 0.5cm-1.5 cm intradermal nodules with overlying hyperpigmentation on his arms (Figure 2).

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