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Thirty-four year old white female patient, presented with facial lesions for the past 14\nyears. At the exam 2-3 mm normochromic papules were distributed mainly around the eyes,\nnostrils and mouth and temporal areas. Also, clustered normochromic papules with a plain\nand smooth surface were present in the dorsal area of the tongue and gingival areas.\nOther visible lesions were: palmoplantar keratosis, with central depression and\nextension to the wrists; one papular, non-pedunculated smooth-surfaced lesion on the\nshoulder and flat wart-like lesions on the dorsal region of hands and lateral parts of\nthe feet ( to ). This patient also had macrocephaly, ogival palate, adenoid\nfacies and palpable thyroid nodules. The largest nodule was biopsied and cytological\nexam showed only hyperplasic cells without evidence of malignancy.\nAnatomopathological exam of a facial papule showed unspecific alterations and the\nshoulder lesion analysis resulted in sclerotic fibroma. We did not observe koilocytosis\non the flat wart-like lesions. Electrocoagulation sessions on the facial papules\nprovided esthetic improvement of the lesions.