II. Epidemiology

  1. Common benign dermatologic condition typically occurring in patients with Skin of Color (e.g. black, asian, hispanic)
  2. Occurs in 10-30% of black patients
  3. Onset after Puberty
  4. More than 50% of patients have a Family History of these lesions (typically multiple family members)

III. Pathophysiology

  1. Idiopathic, benign lesions
  2. Not related to nevi (despite being referred to by patients as "moles")

IV. Symptoms

  1. Typically asymptomatic
  2. May be mildly pruritic

V. Signs

  1. Characteristics
    1. Multiple Brown to dark brown, dome-shaped Papules, filliform or sessile
    2. Lesions are each 1 to 5 mm in diameter, and raised 1 to 3 mm off the skin surface
  2. Distribution
    1. Face, neck and trunk
    2. Typically develop in a symmetrical pattern
  3. Course
    1. Increase in size and number with age

VI. Management

  1. Treatment is not needed and cosmetic only
  2. Treatment risks Postinflammatory Hyperpigmentation
  3. Destructive techniques
    1. Excision with scissors
    2. Laser Therapy
      1. Higher rates of clearance with less Postinflammatory Hyperpigmentation
      2. Magfour (2021) J Drugs Dermatol 20(4): 467-72 [PubMed]
    3. Electrodesication and curettage
    4. Cryotherapy
    5. Microdermabrasion

VII. Prevention

  1. Sunscreen
    1. Cummulative UV light exposure is a risk factor for development

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