Brown Plaque with Ripple-pattern on Nasolabial Fold

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A 12-year-old boy presented with a 6-month history of asymptomatic brown plaques on his nasolabial fold which had not disappeared despite repetitive cleansing with soap and water. Physical examination showed a ripple-pattern area of brown plaque with well-defined borders on his nasolabial fold (Figure 1). No other body part was involved and there were no systemic symptoms. A punch biopsy taken from his nasolabial fold showed papillomatosis of the epidermis associated with irregular acanthosis and prominent lamellar hyperkeratosis with intracorneal orthokeratotic whorls.

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