Fleshy papules in areas of friction in a man with endocrine neoplasms.

Histologic evaluation of biopsy specimens from both the neck and the abdomen demonstrated an expansile dermis composed of thick whorls of collagen bundles consistent with collagenomas (Figure 3). The presence of cutaneous collagenomas and multiple endocrine neoplasms is most consistent with MEN1. Subsequent genetic analysis of MEN1 was positive for a heterozygous deletion (c.1670-1672delAGA) known to be associated with MEN1. Our patient underwent resection of all 4 parathyroid glands, and distal pancreatectomy is pending. Also, he will follow standard MEN1 screening guidelines for other neoplasms. Genetic testing of his asymptomatic family members, including his children, is also pending, as screening for MEN1 begins at the age of 5 years.