Abstract
An 8‐year‐old Chinese boy was referred to the National Skin Centre (NSC) for evaluation of multiple white asymptomatic papules of 2 weeks duration. These lesions appeared suddenly on the face, neck, trunk, and extremities. There was no family history of a similar papular eruption. He was otherwise in good health.Physical examination revealed numerous discrete whitish domeshaped papules measuring 1 to 2 mm in diameter. These were of a bilateral and symmetrical distribution on the lower eyelids, posterior auricular area, neck, dorsal and ventral aspects of the arms (Figs. 1 and 2) and legs, chest, abdomen, and back. Most of the lesions were soft, some firm, smooth surfaced, noncrusted papules. Our first impressions were epidermal cyst, lichen nitidus, milia, histocytic lesion, or rare case of eruptive syringoma.The first skin biopsy was done from a firm papule on the right arm. Hematoxylin and eosin staining revealed cystic structures filled with bluish material in the upper dermis and a few basophilic epithelial cords in the surrounding connective tissue stroma. Von Kossa stain showed the presence of calcium in the cyst.On the second visit, we noticed new crops of papular lesions, which were smaller and softer than previous ones. The second biopsy was done from the right forearm, at this time we saw basophilic cells in cords and in tadpole‐like configuration with a normal connective tissue stroma; this confirmed syringoma (Fig. 3).
Published Version
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