Forehead and Temples

Forehead and Temples


Molluscum contagiosum, flat warts, acne vulgaris, rosacea, seborrheic dermatitis, and benign neoplasms, such as various nevi, tend to appear on the forehead and temples in children and young adults. In older individuals, seborrheic keratoses, sebaceous hyperplasia, and sun-related growths, such as actinic keratoses, basal cell carcinomas, and squamous cell carcinomas frequently appear on the forehead and temples.


Molluscum Contagiosum

Distinguishing Features

  • Dome-shaped, “waxy,” or “pearly” appearing papules with a central white core (umbilication); less frequently, lesions are pink to flesh-colored (Fig. 3-1)

  • Generally, lesions are 1 to 3 mm in diameter, but may coalesce into double or triple lesions and become so-called “giant” mollusca (more often noted in patients who are significantly immunocompromised)

  • Frequently grouped via autoinoculation from scratching or manipulation; lesions may be widely disseminated to trunk, extremities, and genital areas

  • Often involves the face, forehead, eyelids (see Fig. 4-3), conjunctiva, as well as intertriginous areas such as the axillae and inguinal creases

  • May appear in young children on eczematous areas (sites with decreased skin barrier integrity)

  • The number of lesions varies from one up to hundreds

  • Generally asymptomatic; may itch and become inflamed and crusted

  • In children, the course is most often self-limiting with lesions resolving within 6 to 18 months

  • Recurrences are rare in immunocompetent children

Flat Warts

Distinguishing Features

  • Small, flat-topped (planar), slightly elevated, skin-colored or tan papules, 1 to 3 mm in diameter (Fig. 3-3)

  • Lesions are subtle (side lighting may be necessary to see them)

  • May present in a linear configuration due to autoinoculation

  • Tend to resolve spontaneously but may persist



Distinguishing Features

  • 1.0 to 2.0 mm in diameter and are white to yellowish asymptomatic papules (Fig. 3-4)

  • Most often noted on the face, frequently on the forehead, cheeks, and around the eyes

Melanocytic Nevus

Distinguishing Features

Junctional Melanocytic Nevi

  • Small, macular (flat), freckle-like; uniform in color (Fig. 3-6) that varies from brown to dark brown to black

  • Acquired or congenital; most prevalent on the face, arms, legs, trunk, genitalia, palms, and soles

Compound Melanocytic Nevi

  • Elevated, dome-shaped papules or papillomatous nodules that are uniformly brown to dark brown (Fig. 3-7); may contain hairs

  • Seen most often on the face, arms, legs, and trunk

Dermal Melanocytic Nevi

  • May be elevated and dome-shaped, wart-like, or pedunculated

  • Tan, brown, or dappled with pigmentation

  • With age they often become skin-colored (Fig. 3-8)