A 9-year-old boy complains facial lesions over several months. His mother has tried several over-the-counter anti-acne remedies without apparent benefit. He is otherwise well. He does not take medication. His family are all well, his parents are non-consanguineous.
Examination He has symmetrically distributed red to pink papules, each measuring 1–3 mm in diameter localized to the nasolabial folds and extending to cheeks, nostrils and also the chin (Figure attached). The individual lesions are smooth and firm. Examination of his skin under Wood’s light demonstrates six hypomelanotic macules over his lower back, abdomen, and buttocks. Both of his parents also agreed to full skin examination and no abnormalities were detected.
