IJWD Image Quiz Challenge

Images in Women's Dermatology Quiz

What is the diagnosis?


A 62-year-old woman presented with a 2-year history of asymptomatic spiny bumps on her flanks, arms, and thighs that arose a few months after she stopped using a tanning bed. She denied any history of radiation, chronic illnesses, or new medications and completed all age-appropriate cancer screenings. There was no family history of similar lesions or malignancy. Physical examination revealed numerous nonfollicular tiny spiny papules akin to church spires on the ventral arms, legs, and flanks (Fig. 1A). There was no facial or acral involvement. Complete blood count, chemistry, thyroid studies, vitamin A, and serum and urine protein electrophoresis results were unremarkable. Histopathology results of shave biopsy tissue revealed discrete foci of vertical parakeratosis emanating atop underlying hypergranulosis (Fig. 1B).