Reactive perforating collagenosis in two siblings

A 5-year-old male child presented with multiple, asymptomatic, raised lesions over dorsum of bilateral hands, feet and face since the age of 1 year. The lesions used to aggravate in winters and heal with superficial scarring. His elder sister (7-years-old) also had a history of similar lesions since the age of 3 years. There was no history suggestive of systemic involvement. Their parents were concerned regarding the superficial scarring on the face. On examination, multiple, discrete, papular lesions with central adherent keratin plug, varying in size from 2 to 5 mm, were present over face, bilateral forearms and legs predominantly distributed over the elbow and …