HPI: A 46 year-old white female with a history of recurrent spontaneous pneumothorax and cystic lung disease presented for evaluation of multiple lesions of the face, neck and upper trunk. The lesions appeared during early adulthood and were asymptomatic and unchanging. She had no known family history of similar skin lesions. Review of systems was negative.
Past Medical History: hypertension, obstructive sleep apnea, osteoarthritis, GERD, cholecystitis s/p cholecystectomy
Family History: Mother – colon cancer; Father – hypertension and CLL; No known family history of renal carcinoma, pneumothorax or cystic lung disease.
Allergies: penicillin, IV contrast dye
Medications: calcium/vitamin D3, multivitamin, ibuprofen, naproxen sodium, venlafaxine, omeprazole, triamterene-hydrochlorothiazide
Social History: no alcohol, no tobacco use
Physical Exam: On examination there were multiple 1-2mm shiny white follicular-based papules of the nose, malar cheek, jawline, lateral neck and upper trunk (Fig. 1).
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