PMC10328097_01
Pedigree chart of the patient (arrow indicates the proband).
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The pedigree chart of her family is shown in Figure 1. 
Clinical presentations: multiple discrete comedone-like hyperkeratotic brownish papules distributed symmetrically on the trunk (A) and extremities (B and C); close-up image of the lesions (D).
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Dermatological examination revealed generalized multiple discrete comedone-like hyperkeratotic brownish papules distributed symmetrically on the trunk and extremities, sparing palms and soles (Figure 2).
Dermoscopic features: brownish, slightly elevated border follicular papules with central keratin plugs (original magnification x20).
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The dermoscopic evaluation showed brownish, slightly elevated border follicular papules with central keratin plugs (Figure 3).
Histopathological findings: (A) cystic dilatation with keratotic follicular plugging (hematoxylin-eosin, original magnification x10) and (B) focal acantholytic dyskeratosis in the cystic epithelium (hematoxylin-eosin, original magnification x100).
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Histologic examination revealed cystic dilatation with keratotic follicular plugging and multiple zones of focal acantholytic dyskeratosis in the cystic epithelium (Figure 4).