Dermatosis papulosa nigra in Adult
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Synopsis

According to a 2003 study among Afro-Caribbean people, more participants with light phototypes (skin type V or less) had the lowest frequency of involvement. In addition to Black individuals, the condition has also been reported in Filipino, Vietnamese, European, and Mexican individuals.
The onset of DPN is typically during adolescence, and lesions initially look like freckles. Women are affected more often than men. There may be a family history of similar lesions. The number of lesions typically increases with age, peaking in the sixth decade. Up to one-third of Black adults have some of these lesions. Approximately 25% of patients with facial lesions will also have lesions at other body locations such as the neck, chest, and back. DPNs also become larger with age.
DPN is a cosmetic concern only. In contrast to SKs, where rapid onset of numerous lesions can be a cutaneous sign of internal malignancy, multiple DPNs are not related to any systemic disease or syndrome.
Codes
ICD10CM:L82.1 – Other seborrheic keratosis
SNOMEDCT:
254669003 – Dermatosis papulosa nigra
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Seborrheic keratoses
- Melanocytic nevi
- Angiofibromas
- Warts
- Acrochordons (skin tags)
- Benign appendageal tumors
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Management Pearls
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Therapy
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References
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Last Reviewed:03/07/2021
Last Updated:01/13/2022
Last Updated:01/13/2022


Overview
Dermatosis papulosa nigra is a harmless condition commonly affecting the faces of black and sometimes Asian adults. The cause of dermatosis papulosa nigra is unknown, although about half of people affected have a family history of the disease.Who’s At Risk
Dermatosis papulosa nigra affects up to 35% of people of African descent and an unknown proportion of Asian individuals. Women are affected more than men. Dermatosis papulosa nigra usually begins in adolescence, and the number and size of lesions increase with age. The spots of dermatosis papulosa nigra do not go away.Signs & Symptoms
Numerous 1-5 mm firm, smooth, raised, dark brown to black bumps occur on the cheeks and forehead. Sometimes these bumps may also be on the neck and trunk.- Mild - less than 10 spots
- Moderate - 10 to 50 spots
- Severe - more than 50 spots
Self-Care Guidelines
No treatment is needed for dermatosis papulosa nigra lesions unless they are bothersome cosmetically.When to Seek Medical Care
When removal of dermatosis papulosa nigra lesions is sought, care must be taken to be conservative to avoid scars and loss of pigment in the skin.Treatment cost is usually not covered by insurance.
Treatments
Freezing (cryosurgery), scraping (curettage), and burning (electrocautery) are all effective removal methods.References
Bolognia, Jean L., ed. Dermatology, pp.1701-1702. New York: Mosby, 2003.