Exophytic growths on the back.

Volume 91, Number 7 www.aafp.org/afp American Family Physician 487 A 26-year-old man presented with a fouryear history of exophytic growths on his back and extensive scarring on his chest. The lesions were flesh colored, nontender, and progressively worsening. His medical history was significant for moderate to severe acne, which required treatment with oral isotretinoin. The lesions gradually developed, extending beyond the borders of inflammatory acne cysts. They significantly affected his appearance and caused severe distress. Physical examination revealed multiple oval and round, hypertrophic, nodular tumors on his back (Figure 1). They ranged in size from 2 to 10 cm. On the anterior chest, there were multiple areas of hypertrophic scars (Figure 2).