Multiple Perifollicular Fibrous Papules of the Neck Mimicking Verruca Plana in an Elderly Woman: A Case Report

Background: Multiple small papular lesions on the neck and face in adults are commonly attributed to viral warts or adnexal tumors, but benign mesenchymal proliferations such as perifollicular fibromas may be overlooked and misdiagnosed. Case Presentation: A 64-year-old woman presented with numerous asymptomatic, skin-colored papules on the lateral and posterior neck and face, progressively increasing over years. Clinical differentials included verruca plana, syringoma, and benign adnexal tumors. Punch biopsy revealed concentric perifollicular dermal fibrosis without viral cytopathic changes or adnexal proliferation, consistent with multiple perifollicular fibromas. Conclusion: Multiple perifollicular fibromas can clinically mimic viral warts. Histopathology remains essential for accurate diagnosis, preventing unnecessary destructive or antiviral therapies.