A 41-year-old woman presented with a 2-year history of multiple asymptomatic pea-sized papules with an erythematous, telangiectatic rim surrounding an atrophic, porcelain-white center on the trunk and extremities (Figure 1). She had experienced abdominal fullness and vomiting for 1 year. Histopathologic examination of a skin biopsy from the left forearm revealed hyperkeratosis, epidermal atroph...