Multiple Papules of the Scalp and Forehead

REPORT OF A CASE A 71-year-old woman presented for treatment of a facial filiform wart. At her first visit, it was noted that her superior forehead and frontal scalp was studded with many firm, smooth, round-to-oval, yellow papules varying from 1 to 5 mm (Figure 1). These lesions were asymptomatic and had been present for several years. None of her family had similar lesions. Her history was remarkable for asthma, hypothyroidism, and a cardiac arrhythmia. Her medications included prednisone, theophylline, albuterol and albuterol sulfate, levothyroxine sodium, di- sopyramide phosphate, conjugated estrogens, and medroxyprogesterone acetate. A representative skin biopsy specimen is shown inFigure 2andFigure 3. What is your diagnosis? Figure 1. Figure 2. Figure 3. Multiple Papules of the Scalp and Forehead DIAGNOSIS: Steatocystoma multiplex (facial papular variant). HISTOPATHOLOGIC FINDINGS In the upper dermis there was an irregular polylobulated cyst containing a small amount of amorphous material. The