Dermatosis papulosa nigra

Dermatosis papulosa nigra

“Doctor, can you remove my freckles?”

Are these freckles? No, they are considered a variant of SKs

Dermatosis papulosa nigra Multiple, small, hyperpigmented, sessile to filiform, smooth-surfaced papules Arise in darker skin types, usually on the cheeks and temples

Treatment considerations

Harmless, but may be a cosmetic issue for some

Would you treat these lesions with liquid nitrogen?

Treatment Discussion

• No. Why not use liquid nitrogen?
  • Freezing could cause unsightly hypopigmentation
    • Melanocytes are very sensitive to cold
• Which “treatment” might you choose?
  • Very light electrodessication is often safest (use of electric current to cause superficial destruction)

Risks of Cryotherapy

• Dyspigmentation after cryotherapy

• This patient had SKs treated with cryotherapy and now has permanent dyspigmentation

• Even with electrodessication, a test spot is in order to determine how the patient is likely to react