Erythematous papules on the face.

Volume 86, Number 11 www.aafp.org/afp American Family Physician 1065 A 19-year-old woman presented with a red rash on her face. The nonpainful bumps had been present for several years and had been unsuccessfully treated with topical retinoids and laser therapy. The patient had a history of seizure disorder and mental retardation. The examination revealed multiple erythematous papules coalescing into plaques around the buccal area of the patient’s face (see accompanying figure). She had mild erythema on her cheeks, forehead, and nasolabial folds. Her face was not warm to palpation, and she did not have open or closed comedones. A 3-mm punch biopsy of the erythematous area showed proliferation of fibrous tissue and perifollicular concentric fibrosis.