© 2003 The International Society of Dermatology International Journal of Dermatology 2003, 42, 295 –296 295 A 21-year-old woman with skin type IV, who had developed photophobia and brown, spotty, hyperpigmented lesions on her face from early childhood, presented to our center for treatment of her facial lesions. Examination on admission revealed numerous, freckle-like, hyperpigmented macules and actinic keratoses over the central part of the face, with sparing of the forehead, chin, and peripheral area (Fig. 1). The area involved was approximated to be around 2% of the total body surface. The dorsal parts of the hands showed no lesions (Fig. 2), but guttate hypomelanotic lesions were apparent on both forearms. Histologic examination of biopsies from four different facial lesions revealed them to be keratoacanthoma (1.5 × 2.5 cm ulcerative nodule on the right cheek), sclerosing basal cell epithelioma (nasal lesion), lentigo simplex, and hypertrophic actinic keratosis. Corneal clouding, conjunctival injection, loss of lashes, and atrophy of the lids were apparent on ophthalmologic examination. Other parts of the physical examination, including examination of the oral cavity, were nonsignificant. In addition, except for the presence of mild eczema in a sibling, the patient’s family history regarding the presence of any similar problem and also any other important dermatologic or general disorder was negative. Blackwell Science, Ltd Oxford, UK IJD International Journal of Dermatology 0011-9059 Blackwell Science, 2002 ? Cameo Xeroderma pigmentosum Mirshams-Shahshahani and Namazi Cameo Xeroderma pigmentosum with limited involvement of the UV-exposed areas: a case report Mostafa Mirshams-Shahshahani, 1 MD, and Mohammad Reza Namazi, MD From the 1 Dermatology Department, Tehran University of Medical Sciences, Tehran, Iran, 2 Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran Correspondence Mohammad Reza Namazi, MD PO Box 71955-687 Shiraz Iran E-mail: namazi_mr@yahoo.com Discussion The first case of xeroderma pigmentosum (XP) with limited involvement of the sun-exposed surfaces is presented. This exotic presentation is in clear contrast with the usual manifes- tation of XP, which involves all sun-exposed sites. XP represents a group of inherited disorders with an estimated prevalence of 4 in 106. 1 Clinically, XP manifests as actinic keratoses, and basal and squamous cell carcinomas, as well as melanomas, which may develop during early childhood in UV-exposed areas. 2 XP serves as the prototype of heritable disease with increased sensitivity to cellular injury. 3 It is an autosomal Figure 1 Limitation of xeroderma pigmentosum lesions to the center of the face Figure 2 Hands are devoid of any lesions