Codes

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Angiofibromas – Usually occur on the face and are often associated with tuberous sclerosis.
• Dermatofibromas – Usually occur on the leg and dimple centrally with lateral compression (Fitzpatrick sign).
• Granuloma annulare – Usually occurs on the extremities; often forms annular lesions without scale or other epidermal changes. When broadly disseminated, granuloma annulare may be associated with diabetes, while MCAs are not.
• Kaposi sarcoma (KS; AIDS-associated and non-AIDS-associated) – Classic KS typically forms on the legs of elderly men, and epidemic KS is associated with HIV infection. KS is caused by infection with human herpesvirus type 8 (HHV-8). It usually appears more purple.
• Sarcoidosis – Most common in African Americans from the southern United States. It may be associated with pulmonary or other systemic involvement, whereas MCAs are not.
• Flat wart – Groups of skin-colored to pink, small papules caused by human papillomavirus (HPV) that are most common in children. Unlike MCAs, flat warts may develop quickly and often spontaneously regress.
• Lichen planus – Look for grayish-white streaks (Wickham striae) overlying flat, purple papules.
• Venous lake – Dark blue to violaceous papules representing dilated venules; most common on the lip or ear in older patients.

Best Tests

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Management Pearls

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Therapy

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References

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