A 68-year-old woman had a 3-year history of violaceous papules located symmetrically on the medial aspect of both thighs (Figure 1). The lesions had been slowly growing in number and size but had remained asymptomatic. There was no family history of skin disease, and the patient had always been in good health, without any history of venous insufficiency. Physical examination revealed 2 red-brown, smooth, well-circumscribed dome-shaped papules, one on the right thigh and one on the left thigh, ranging from 5 to 10 mm in diameter. A 4-mm punch biopsy specimen of a lesion on the right thigh was stained with hematoxylin-eosin (Figure 2 and Figure 3).