LAUSR

262 I CUTIS WWW.MDEDGE.COM/DERMATOLOGY PLEASE TURN TO PAGE 268 FOR THE DIAGNOSIS A 3-year-old girl presented with raised, firm, enlarging, asymptomatic, well-defined, subcutaneous papules, plaques, and nodules on the hands, knees, and posterior ankles of 1 year’s duration. The patient’s mother stated that the lesions began on the ankles (top), and she initially believed them to be due to friction from the child’s shoes until the more recent involvement of the knees and hands. The patient’s father, paternal grandfather, and paternal great-grandfather had a history of elevated cholesterol levels. A shave biopsy was performed (bottom).