Case Report A nine-year-old, white Brazilian boy presented with skin lesions present since the age of 2 years.His parents were nonconsanguineous and he had no family history of significant skin disease. Physical examination revealed hundreds of very firm, pinkish or yellowish nodules of various sizeswidely distributed on the trunk, buttocksand limbs.Thenoduleswerenot freelymobile, being adherent to more extensive deep masses which were covered by erythematous skin (Fig. 1A,B). Some older nodules showed a depressed and atrophic surface. Pain was minimal but joint mobility was moderately impaired and some muscle atrophy was present on the limbs. No other signs of significant skin or systemic illnesses were observed. Investigation included full blood count, serum calcium and phosphate, renal function, muscle enzymes and anti-nuclear antibodies; the only abnormality found was a mild anaemia. A radiograph of pelvis and femora is shown in Fig. 2A. Histopathology of a removed nodule is shown in Fig. 2B.