A 45-year-old white woman was referred to the department of dermatology for evaluation of asymptomatic lesions on her right lower leg. The lesions had first appeared approximately 8 years earlier and had remained unchanged. The patient denied fever or constitutional symptoms. Her other medical problems included rheumatoid arthritis and type II diabetes mellitus.The findings of the physical examination revealed approximately 20 discrete, 4-to 6-mm firm, nontender, erythematous, blanchable papules on the anterolateral aspect of the right leg below the knee (Figs 1 and 2). The surface of the lesions appeared normal. A 4-mm punch skin biopsy specimen was obtained (Figs 3 and 4).