PMC7529176_01
(a) Multiple hyperpigmented dome-shaped papules over the lower abdomen, (b) multiple flat wart-like lesions over the penis and scrotum
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F1
On examination multiple hyperpigmented dome shaped papules over lower abdomen. [Figure 1a] and some warty papules present over penis and scrotum. [Figure 1b] There were no hypopigmented macules over any part of body.
Hyperkeratosis, acanthosis, and vacuolated cells in the upper stratum malpighiand granular layer keratinocytes have basophilic cytoplasm containing keratohyalin granule (H and E, x4)
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F2
Keratinocytes have basophilic cytoplasm containing keratohyalin granules, suggestive of EDV [Figure 2].
Hyperkeratosis, acanthosis, and papillomatosis. The rete ridges were elongated and bent inward at both margins with large vacuolated cells in the upper stratum malpighi (H and E, x4)
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F3
Dermis showed mild perivascular lymphoplasmacytic infiltration [Figure 3].