REPORT OF A CASE
A 38-year-old woman presented with numerous warty papules on the dorsum of her hands and on the lateral aspect of her fingers (Figure 1 and Figure 2). Her medical history dated back to her childhood, when her parents noted that she had a husky voice, progressive widespread yellowish papules, and multiple dental caries. By 14 years of age, she was edentulous (Figure 3). She also suffered from seizures (grand mal) and, more recently, underwent thyroid surgery for adenoma.On physical examination, she had yellowish, waxy papules on the borders of her eyelids, ears, nose, and lips and on the lateral aspect of her fingers. Warty, brownish plaques and papules were present on the extensor aspect of her elbows, hands, and knees as well. The oral mucosa was also involved, with plaques on the tongue and pharynx. Areas of alopecia were present on her scalp and eyebrows.