Since she was about 2 years old, this now 14-year-old girl has had asymptomatic bumps on her arms and face. They are most noticeable in the wintertime and a bit less conspicuous during humid months. Besides the appearance of the lesions, the patient is annoyed by the rough feel of them, which is unaffected by her use of OTC moisturizers and lotions.
Her mother recalls having the same problem as a child but says it improved with time. The patient’s immediate family members are all atopic, with seasonal allergies and eczema.
EXAMINATION
The patient is Hispanic with type IV skin. Dense patches of brown, tiny, rough, papulofollicular lesions cover the surface of both posterior triceps. They are also visible on the patient’s anterior thighs and the posterior two-thirds of her face.
What is the diagnosis?