Dermatosis papulosis nigra (DPN) is a common affliction on the face and neck of skin of color patients, with an incidence of upwards of 70%, being more common in women. When DPN was first described in 1925, it was thought that it was a genetic problem of West Africans; however, it has occasionally been diagnosed in white patients. While the etiology is unclear, it is likely that it is viral in origin, as the histology resembles that of seborrheic keratoses. Then human papillomavirus that causes the common wart would be implicated. There is no evidence that DPN is of a genetic predisposition, but a familial pattern can be accepted.
DPNs are 1 to 4 mm brownish to black elevated lesions. Occasionally, they create itching, but their dislike by patients centers on making make-up a problem and their association with aging. Treatment is easy with destruction by snipping or electrodesiccation. Cryosurgery is usually not recommended, as it can result in temporary hypopigmentation around the surgical site.
Lawrence Charles Parish, MD, MD (Hon)
Philadelphia, PA, USA