A 10-year-old girl presented with multiple skin-coloured and hyperpigmented, slightly hyperkeratotic, flat-topped papules (2-5 mm) over her forehead. The papules were mostly distributed linearly. A few scattered similar-looking lesions were also seen (Fig. 1). Based on the characteristic features a diagnosis of verruca plana was made.

Fig. 1 Multiple skin-colored, hyperkeratotic flat-topped papules over the forehead.

Verruca plana, caused by human papilloma virus, is frequently seen in children and young adults. The lesions are usually distributed in photo-exposed areas like face, neck, and dorsum of the hands. Contiguous warts may coalesce to form larger plaque. Linear arrangement of the papules at the sites of scratching (koebnerization) is characteristic. Common differential diagnoses of this condition include acne (polymorphic lesion, presence of comedone, common in acne-prone area), molluscum contagiosum (pearly, skin-colored papules with central umbilication), syringoma (small, firm skin-coloured, translucent papules, common on the lower eyelids), and adenoma sebaceum (pink, dark brown, or skin-colored telangiectatic papules).