Primary multiple miliary osteoma cutis and exogenous ochronosis

Multiple miliary osteoma cutis (MMOC), a rare disorder characterized by the appearance of numerous bony nodules on the face, was initially classified as a consequence of severe, longstanding acne vulgaris. However, several cases have now been described in patients with no preceding history of acne or other inflammatory conditions. We report such a case of primary MMOC in a 75-year-old African American woman and highlight the differences between these conditions. We also note the incidental histologie finding of exogenous ochronosis, which, in our case, indicates the patient's use of hydroquinonecontaining bleaching creams in an attempt to treat the disorder.