Numerous hyperpigmented macules on the trunk

Abstract

A 17-year-old man presented with a lifelong history of hyperpigmented lesions on his trunk and proximal limbs. He seemed otherwise healthy. The lesions had developed at approximately 2 months of age and increased in size and number until 5 years of age. The lesions had remained stable for the past 12 years of his life and were asymptomatic with no pruritus or pain; however, they seemed to become more prominent after warm showers. On physical examination, numerous reddish-brown macules and thin papules 4–8 mm in size were found, scattered over the trunk and proximal limbs, with relative sparing of the face and distal limbs (Fig. 1). Punch biopsy specimens were obtained from the patient s arm and upper back.