Suspicious papules on nose, chest and back

Presenter: Angela Macri DO, Christopher Cook DO FAOCD, FAAD, Jonathan Crane DO FAOCD, FAAD
Dermatology Program: Sampson Regional Medical Center
Program Director: Jonathan Crane DO, FAOCD, FAAD
Submitted on: Sep 7, 2017

CHIEF COMPLAINT:  A 41 year old Caucasian female presented to our dermatology clinic for new lesions that appeared on her nose, chest, and back over the past year.

CLINICAL HISTORY:

Signs and symptoms:  The lesions were not changing in size, were not painful or pruritic, and have not bled.

Previous Treatment:  none

Other information:  Her past medical history included colon cancer diagnosed at age 21, depression, GERD, squamous cell carcinoma of the vulva, and basal cell carcinoma diagnosed at age 25. Surgical history included total hysterectomy, colectomy, vulvectomy, and cholecystectomy. Her family history on her paternal side included colon cancer diagnosed in her father, grandfather, aunt, and two uncles. Her paternal aunt was diagnosed with breast cancer.

PHYSICAL EXAM:

Several, 2-3 mm yellow to flesh colored smooth papules located on her nose, chest, and back

LABORATORY TESTS:

None

DERMATOHISTOPATHOLOGY:

Greater than 50% basaloid cells lining sebaceous glands with only a few mitotic figures confirming the diagnoses

DIFFERENTIAL DIAGNOSIS:

1.   Keratoacanthomas
2.   SCC
3.   BCC
4.   Trichoepithelioma
5.  Sebaceous Epithelioma

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