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 ca ses have now been described in patients with no preceding history of acne o r other inflammatory conditions. We report such a case of primary MMOC in a 75-year-old African American woman and highlight the differences between t hese conditions. We also note the incidental histologic finding of exogenou s ochronosis, which, in our case, indicates the patient's use of hydroquino ne-containing bleaching creams in an attempt to treat the disorder.