CMAJ • SEPTEMBER 15, 2009 • 181(6-7) © 2009 Canadian Medical Association or its licensors 397 A23-year-old man was referred to us with a 4-year history of flesh-coloured, spiny papules around the coronal rim of his glans penis (Figure 1). The papules were 1–2 mm in diameter. The patient felt stigmatized by their appearance. A diagnosis of pearly penile papules (also known as PPP) was made. Pear...

Biopsy was performed of one of the lesions: in the superficial dermis, beneath a normal epidermis, there was a diffuse proliferation of histiocytic cells with clear, foamy cytoplasm; in some areas Touton giant cells could be identified (Figure 2). There was also a moderate degree of vascular proliferation. Immunohistochemistry was positive for S100, CD68, and for CD34 (in the vessels) and was n...

Dear Editor, A 24-years-old female sought medical assistance with complaints of a two-year history of bumps on her heels, initially asymptomatic, getting intensely painful over the time. She was generally healthy, and practiced running regularly. Physical examination revealed multiple skin-colored papules on both heels, more evident under pressure (Figure 1). Histopathological exam showed thick...

Verruca plana, caused by human papilloma virus, is frequently seen in children and young adults. The lesions are usually distributed in photo-exposed areas like face, neck, and dorsum of the hands. Contiguous warts may coalesce to form larger plaque. Linear arrangement of the papules at the sites of scratching (koebnerization) is characteristic. Common differential diagnoses of this condition i...

We present the case of a 58-year-old man, with no past history of interest, who was seen for skin lesions on the dorsum of the hands and feet, the legs, and the forearms. The lesions had been present for approximately 20 years and were completely asymptomatic; they became more prominent in the summer, due to pigmentation of the surrounding skin. Their number and the area affected had increased ...