Enliven: Clinical Dermatology

Dermatosis papulosa nigra is a common, benign skin condition characterized by multiple, asymptomatic, superficial, black or dark-brown, round, domeshaped or flat, macules or more often papules. The size of individual lesion usually ranges from 1 to 5 mm. Sites of predilection include the face, neck, and upper trunk. Dermatosis papulosa nigra occurs predominantly in darker-skinned individual. The incidence increases with age and is rare before puberty. The male to female ratio is approximately 1:2. There is a genetic predisposition. Ultraviolet irradiation may have a role to play. Activating point mutations of the FGFR3 and the PIK3CA genes are involved in the pathogenesis. Treatment is usually not necessary apart from reassurance about the benign nature of the condition. For those patients in whom treatment is desired mainly for esthetic reasons, treatment options most commonly include: curettage, ablative laser, excision, and electrofulguration. Liquid nitrogen cryotherapy can also be tried in some cases with great care due to higher risk of side effects.